Allograft bone tends to cause resorption of the patient's own bone (osteolysis) at the graft/vertebral endplate interface early in the postoperative course, and can lead to further instability. About Titan Spine - Titan Spine, LLC is a privately owned company in Mequon, Wisconsin focusing on the design and manufacturing of bioactive interbody fusion devices for the spine.
Reviewed submitted version of manuscript: all authors. The device provides immediate binding to the endplates. J Spine Surg. Mean values are presented ± SD.
In the few instances that an expandable LLIF was used, the cages were maximally expanded and thus categorized into the 15°–20° cohort. Sharma AK, Kepler CK, Girardi FP, Lateral lumbar interbody fusion: clinical and radiographic outcomes at 1 year: a preliminary report.
This required a large bone graft to be taken from the patient's iliac crest, and had a fairly high complication rate (such as postoperative chronic pain, infection, pelvic fracture). Anterior cage position appeared to be particularly important to achieving SL, as an anteriorly positioned cage was the only independent correlate with SL change in our multivariate linear regression model. Founded in 2005, the company is committed to developing the best Almost all cages are MRI-compatible for postoperative imaging. Landham PR, Don AS, Robertson PA. Do position and size matter? Skovrlj B, Belton P, Zarzour H, Qureshi SA. J Biomed Inform. Modulus® Titanium Technology Unlike any other 3D printed titanium implant on the market, Modulus is designed through a proprietary optimization algorithm that balances strength and radiolucency. As with any other spine fusion procedure, the implant used is largely dictated by what the treating spine surgeon prefers and has had the most success with in the past.
2014;36(5):E14. Surgical levels were classified on lateral radiographs based on the cage lordotic angle (6°–8°, 10°–12°, and 15°–20°) and the position of the cage in the disc space (anterior vs posterior). All Rights Reserved.
Interbody fusion devices include titanium (Ti) and polyetheretherketone (PEEK) cages with distinct biomechanical properties. version.2020.05.028-2020.05.006, Ask questions and share your experiences in our new, Anterior Lumbar Interbody Fusion Spinal Implants and Bone Grafts, Anterior Lumbar Interbody Fusion (ALIF) Surgery, Potential Risks and Complications with ALIF Surgery, ACDF: Anterior Cervical Discectomy and Fusion, Postoperative Care for Spinal Fusion Surgery, Spinal Fusion Surgery Recovery: 1 to 3 Months After, Spinal Fusion Surgery Recovery: 3 Months and After, Spinal Cord Stimulator for Chronic Back Pain. Kevin Gemas, President of Titan Spine, stated, “The Analysis and interpretation of data: all authors. Second, we only measured postoperative radiographs in the early postoperative period (2–6 weeks). 5. Titan Spine's proprietary nano surface technology relies on titanium, a material used in orthopedics because of its high strength, low weight and ability to promote osteointegration for lasting and firm fixation. Once the ENDOSKELETON® TA successful; a biomechanically relevant design, Eighty-three (71.6%) patients had a cage placed in the anterior half of the disc space (Table 1). Change in SL was the primary outcome of interest.
There were 77 patients who had 93 levels treated with a titanium cage and 40 patients that had 51 levels treated with PEEK cages. Spine J. These designs support anterior cervical and anterior, posterior, oblique, and lateral approaches to the lumbar spine.
An anteriorly positioned cage was the only independent correlate with increased SL change (p = 0.016). that must be balanced with the goals of surgery.
2018;29(3):399–406. For TLIF, expandable cages had a set cage lordotic angle of 8° or 15°, and height was then adjusted until the maximum “tension” was reached.
C and D: Radiographs at 6 weeks postoperatively, with SL measured as 15.5°. Carlson BB, Saville P, Dowdell J, Restoration of lumbar lordosis after minimally invasive transforaminal lumbar interbody fusion: a systematic review.
Solving for price transparency while improving the patient experience: Are you ready? Int J Spine Surg.
Values are presented as number of patients (%) unless otherwise indicated. Groth AT, Kuklo TR, Klemme WR, Comparison of sagittal contour and posterior disc height following interbody fusion: threaded cylindrical cages versus structural allograft versus vertical cages. Perioperative outcomes in minimally invasive lumbar spine surgery: A systematic review. JBMR Plus.
Whether a spine surgeon approaches the disc space from an anterior approach or from one of the posterior approaches (PLIF, TLIF) is largely dependent on how comfortable the surgeon is with the anterior approach and operating around the aorta and vena cava. LLC is a privately owned company in Mequon, Wisconsin focusing on the ENDOSKELETON® TT is a continuation of the design principles that made J Spinal Disord Tech. Acosta FL, Liu J, Slimack N, Changes in coronal and sagittal plane alignment following minimally invasive direct lateral interbody fusion for the treatment of degenerative lumbar disease in adults: a radiographic study. They hypothesized that this design avoided the posterior intervertebral “bony block” created by the other devices, allowing for differential distraction of the disc space.34 The fact that our technique differed from these series only speaks more strongly to the need for an anteriorly placed cage. The authors performed a retrospective review of a single-surgeon database of adult patients who underwent primary LIF between April 2017 and December 2018. Posterior Lumbar Interbody Fusion (PLIF) Surgery, ALIF (Anterior Lumbar Interbody Fusion) Video, Back Surgery Video: How Spinal Fusion Stops Back Pain, Transforaminal Lumbar Interbody Fusion (TLIF) Back Surgery. Tiger Woods: Reborn.
Watkins RG IV, Hanna R, Chang D, Watkins RG III.
Mean values are presented ± SD.
2010. We are more confident than ever that the Endo TT will greater surface area contact clearly resonates with the surgeon when 3. © Copyright ASC COMMUNICATIONS 2020. Interbody Cage Courtesy: Titan Spine A study of Titan Spine, LLC Endoskeleton titanium interbody cage, presented at the 13th Annual Meeting of the International Society for the Advancement of Spine Surgery, found that the device achieved rapid lumbar fusions. Allograft bone (cadaveric bone) can be milled to a shape like a titanium implant (cylindrical), or more commonly, it is a femoral ring that can be shaped by the physician to fit the disc space. Although x-ray visualization of the bone fusion is limited with titanium devices, the fusion can readily be imaged with a CT scans. The portion of the endplate that contained the majority of the cage footprint was then utilized to categorize the cage position. World J Orthop. | Using endplate sparing techniques and devices allows for less risk of subsidence.
Two years after surgery, 56.2 percent of the titanium group and 71.4 percent of the PEEK group reported nonunion. 2011;15(1):92–96. It works better at L5-S1 where there is little motion. The PEEK group reported sensitivity at 53.8 percent and specificity at 100 percent.
spine.
Curr Rev Musculoskelet Med. products for the treatment of various pathologies that cause back pain.
1999-2020 Veritas Health, LLC. 2009;64(5):955–964. In contrast, our analysis was designed to explicitly compare the change in SL between lordotic cage angles; furthermore, our minimum cage lordosis in the comparisons was 6° (as opposed to 0°). An ALIF spine surgery can also be done with an allograft bone implant. Our investigation was not without limitations. from the U.S. Food and Drug Administration April 15, 2009. 2014;22(12):800–809. The ENDOSKELETON® TT received 510(k) clearance For both groups, the nonunion rate was 100 percent with patients who had a positive cyst sign one year after surgery.
While we did not specifically look at the cage footprint in our series, surgeons should consider the trade-off between a larger footprint to decrease subsidence and the potential for a posterior “bony block” if the cage cannot be placed far enough anteriorly, especially if inducing SL is a surgical goal. The small increase in SL achieved in our series is in line with the findings of other investigators who have utilized the same technique.13,26 Khechen et al. Although threaded titanium cages initially were the only spinal implants that were available, there is now an assortment of cages in different shapes, sizes and materials. Data were collected and managed using REDCap (Research Electronic Data Capture) and supported by the following grant: CTSC GRANT UL1 TR002384. Thus, expandable TLIF cages were classified in the 6°–8° or 15°–20° cohorts. Values are presented as number of cages. This leads to a failure of the endplates, with the cage subsiding into the vertebral bodies. Cage heights were chosen by attempting to attain the same height as the disc above the surgical level, with adjustments made intraoperatively depending on the difficulty of cage insertion. Surgeons who wish to create large increases in lordosis with MIS interbody fusion should consider resection of the posterior elements or release of the ALL, as there is a ceiling effect to the amount of lordosis that can be generated by the cage alone. J Spinal Disord Tech. Patient medical records were reviewed to retrieve demographic and surgical information, including age, sex, BMI, surgical approach, index level, and the manufacturer-reported lordotic cage angle. Pairwise comparisons with Bonferroni corrections reported for the SL changes only. Therefore, we maintain that this limitation did not influence the overall conclusion of the study—lordotic cages do not have a statistically or clinically significant role in generating lordosis during MIS interbody fusions for degenerative lumbar pathology. The researchers examined 117 patients who underwent treatment from March 2005 to July 2012.
bone graft not only through the cage, but also to fully pack the
One solution has been to use radiolucent cages (made of either carbon fiber or PEEK).
Spinal interbody fusion is a standard and accepted method for spinal fusion. An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction.
Compared with cage lordotic angle, cage position and approach play larger roles in the generation of SL in 1–2-level MIS for lumbar degenerative disease. Haque RM, Mundis GM Jr, Ahmed Y, Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients. Without a doubt I would recommend the surgery that I had because I have my life back. 2019;95:103208.
Most spine surgeons have not had a great deal of experience doing the procedure by themselves, and not all spine surgeons have access to a skilled vascular surgeon to help them with the approach. From our pioneering origins over a quarter-century ago to an industry leader today, Centinel Spine offers the widest breadth & depth of technology platforms to anteriorly address spinal disease.
patient outcomes. Now, the only total disc replacement system in the U.S. approved for two-level use in the lumbar spine. Generally, allograft bone is not as strong as other implants. Our findings support the following conclusions: 1) the lordosis achieved through TLIF or LLIF techniques likely depends more on anatomical limitations than the cage lordotic angle, and 2) anteriorly positioned cages are mandatory for optimizing lordosis during MIS interbody fusions.
Find Out More About the No Profile® ALIF Device that Helped Tiger Woods Regain His Life. Multivariate linear regression was performed to identify independent correlates with the primary outcome of interest (change in SL).
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