Hanssen, J.L.J. (2012) De lange termijn effecten van een stand-alone anterior lumbar interbody fusion (STALIF) polyetheretherketon cage gevuld met gesiliceerd tri-calcium fosfaat (actifuse™) op pijn en rugfunctie bij patiënten met een degeneratieve discus disease (DDD). thesis, Medicine.
Full text available on request.Abstract
Goal: To asses the long-term outcomes of a stand-alone anterior lumbar interbody fusion (STALIF) with a polyetheretherketone (PEEK) cage filled with silicated tri-calcium phosphate (actifuse™) in patients with degenerative disc disease (DDD). Background: Patients with degenerative disc disease who fail to respond to conservative therapy are eligible for a lumbar artrodesis. There is a wide variety of surgical techniques to establish lumbar fusion, one of which is an anterior fusion. In the past an anterior lumbar interbody fusion (ALIF) was considered as too unstable what sometimes lead to an adjuvant dorsal stabilisation. In the meantime a STALIF procedure is developed that can guarantee stability without the need of extra dorsal instrumentation because of the specific anatomical shape of the cage. This procedure involves a cage made of polyetheretherketone filled with osteoconductive material (actifuse™) which stimulates arthrodesis. Furthermore, two or three screws are placed through the adjacent vertebral corpora for extra stability. However, there is not much known about long term clinical effects of this STALIF procedure. Methods: Forty five patients treated at the Isala Clinics, Zwolle between 2006 and 2010 were included in the final analysis. All patients underwent surgery because of radiographic proven narrowing of the disc space and a reduction of pain when wearing a plaster corset with a legpiece or a positive discography. All patients completed questionnaires before surgery and 6 weeks, 3 months and 2 years after surgery. Pain was measured by the Visual Analogue Scale (VAS) and function by the Quebec Back Pain Disability Scale (QBPDS). Patients underwent imaging 1 year postoperatively. Results: The mean follow-up was 43,5 months. The mean VAS score decreased from 5,4 before surgery to 2,3 after two years (P<0,005). The mean QBPDS improved from 56 before surgery to 29 after two years (P<0,05). Improvement of pain and clinical outcome is seen in 74,4% of the patients. The rate of reoperations and complications is comparable to that of dorsal fusion techniques. One year postoperative 89% of the patients had solid anterior interbody fusion by radiograph. Conclusions: STALIF is an effective method to treat patients with chronic low back pain caused by DDD. It improved clinical outcomes and reduced pain. About a quarter of the patients however, does not seem to benefit from the procedure. Further research is needed to identify factors that predict a poor clinical outcome.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Niet bekend |
| Supervisor name: | Niet bekend |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2330 |
Actions (login required)
 |
View Item |