FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Der Orthopade2015; 44(2); 104-113; doi: 10.1007/s00132-015-3076-1

[Interbody fusion procedures. Development from a historical perspective].

Abstract: The development of interbody fusion now stretches over many decades and is still not complete. Conclusions: Due to the lack of appropriate implants, the initial fusions were performed via decortication of the dorsal and lateral structures of the spine, followed by placement of an autograft. Despite acceptable fusion results, better primary stability and higher fusion rates were desired. In addition, it became known that the primary load-bearing of the spine is located ventrally in the area of the corpus of the vertebrae. These considerations led to the development of the PLIF technique that was introduced by Cloward in 1953 and gained significantly in popularity. After removal of the intervertebral disc, he positioned iliac crest bone blocks between the vertebral bodies. Based on this technique and these considerations, intervertebral implants were developed in the 1970s. The so-called Bagby Basket was the first intervertebral cage that was initially used in horses with wobbler syndrome. Other milestones in the improvement of the cage designs followed, resulting in the production of different implant shapes and materials. The elastic modulus of the interbody implants approached by modern materials became more and more similar to bone, so that subsidence of cages reduced and the fusion rate could be further increased. The primary stability could be further increased with screw-rod systems, so that dorsal instrumentation became the standard in the context of PLIF and TLIF procedures today. The TLIF procedure described by Harms was a new modification and minimized complications of lumbar fusions and reduced the invasiveness of the procedure. Conclusions: Nowadays a wide variety of implants and implantation techniques are available, making interbody fusions in PLIF and TLIF techniques safe and successful procedures.
Get Full Text
Publication Date: 2015-01-30 PubMed ID: 25626703DOI: 10.1007/s00132-015-3076-1Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • English Abstract
  • Journal Article
  • Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Interbody fusion procedures, which have been developing over several decades, are procedures that help in achieving spinal fusion. The paper traces the development of these procedures from initial fusions performed with autografts to the refined techniques of today that utilize a variety of implants and implantation techniques.

Early Interbody Fusion Procedures

  • The study elucidates on the early fusion procedures where due to lack of proper implants, fusions were conducted via decortication, a process of removing a bone surface, of the dorsal and lateral structures of the spine, with autograft placement following suit.
  • Desired improvements were needed in achieving better primary stability and higher fusion rates even though the initial results were satisfactory.

Development of PLIF Technique

  • The development of the Posterior Lumbar Interbody Fusion (PLIF) technique marked a significant turn in fusion procedures. It became widely accepted after its introduction by Cloward in 1953.
  • To conduct a fusion using the PLIF technique, the intervertebral disc was removed and in its place, iliac crest bone blocks were place between the vertebral bodies.

Advent of Intervertebral Implants

  • The 1970s witnessed an evolution in the interbody fusion procedures with the development of intervertebral implants. The so-called Bagby Basket was the first of its kind and was initially used in horses suffering from wobbler syndrome.
  • Following this development, improvements in cage designs ensued resulting in implants of varying shapes and materials. The modern implants bear an elastic modulus similar to bone, reducing the chances of subsidence and increasing fusion rates.

Improvement in Stability with Screw-Rod Systems

  • This procedure’s primary stability saw a massive boost with the use of screw-rod systems, making the use of dorsal instrumentation standard in carrying out PLIF and Transforaminal lumbar interbody fusion (TLIF) procedures.
  • The TLIF procedure, introduced by Harms, was an innovative modification that brought down the complications associated with lumbar fusions and made the procedure less invasive.

Conclusion

  • Today, interbody fusions in PLIF and TLIF techniques are considered safe and successful owing to the assortment of implants and implantation techniques available.

Cite This Article

APA
Rickert M, Rauschmann M, Fleege C, Behrbalk E, Harms J. (2015). [Interbody fusion procedures. Development from a historical perspective]. Orthopade, 44(2), 104-113. https://doi.org/10.1007/s00132-015-3076-1

Publication

Der Orthopade
ISSN: 1433-0431
NlmUniqueID: 0331266
Country: Germany
Language: ger
Volume: 44
Issue: 2
Pages: 104-113

Researcher Affiliations

Rickert, Marcus
  • Abteilung für Wirbelsäulenorthopädie, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt a.M., Deutschland, marcus.rickert@friedrichsheim.de.
Rauschmann, Michael
    Fleege, C
      Behrbalk, E
        Harms, J

          MeSH Terms

          • Bone Plates
          • Bone Screws
          • Humans
          • Internal Fixators
          • Intervertebral Disc / surgery
          • Prostheses and Implants
          • Prosthesis Design
          • Spinal Fusion / instrumentation
          • Spinal Fusion / methods

          References

          This article includes 43 references
          1. Roy-Camille R, Roy-Camille M, Demeulenaere C. [Osteosynthesis of dorsal, lumbar, and lumbosacral spine with metallic plates screwed into vertebral pedicles and articular apophyses].. Presse Med (1893) 1970 Jun;78(32):1447-8.
            pubmed: 4913929
          2. Barnes B, Rodts GE Jr, Haid RW Jr, Subach BR, McLaughlin MR. Allograft implants for posterior lumbar interbody fusion: results comparing cylindrical dowels and impacted wedges.. Neurosurgery 2002 Nov;51(5):1191-8; discussion 1198.
            pubmed: 12383364doi: 10.1097/00006123-200211000-00014google scholar: lookup
          3. el-Masry MA, Khayal H, Salah H. Unilateral transforaminal lumbar interbody fusion (TLIF) using a single cage for treatment of low grade lytic spondylolisthesis.. Acta Orthop Belg 2008 Oct;74(5):667-71.
            pubmed: 19058702
          4. Bagby G. The Bagby and Kuslich (BAK) method of lumbar interbody fusion.. Spine (Phila Pa 1976) 1999 Sep 1;24(17):1857.
            pubmed: 10488519doi: 10.1097/00007632-199909010-00019google scholar: lookup
          5. HARRINGTON PR. Treatment of scoliosis. Correction and internal fixation by spine instrumentation.. J Bone Joint Surg Am 1962 Jun;44-A:591-610.
            pubmed: 14036052
          6. Brantigan JW, Steffee AD. A carbon fiber implant to aid interbody lumbar fusion. Two-year clinical results in the first 26 patients.. Spine (Phila Pa 1976) 1993 Oct 15;18(14):2106-7.
            pubmed: 8272967doi: 10.1097/00007632-199310001-00030google scholar: lookup
          7. JASLOW IA. Intercorporal bone graft in spinal fusion after disc removal.. Surg Gynecol Obstet 1946 Feb;82:215-8.
            pubmed: 21011710
          8. Magerl FP. Stabilization of the lower thoracic and lumbar spine with external skeletal fixation.. Clin Orthop Relat Res 1984 Oct;(189):125-41.
            pubmed: 6478690
          9. Dick W, Kluger P, Magerl F, Woersdörfer O, Zäch G. A new device for internal fixation of thoracolumbar and lumbar spine fractures: the 'fixateur interne'.. Paraplegia 1985 Aug;23(4):225-32.
            pubmed: 3900882doi: 10.1038/sc.1985.38google scholar: lookup
          10. Zhou J, Wang B, Dong J, Li X, Zhou X, Fang T, Lin H. Instrumented transforaminal lumbar interbody fusion with single cage for the treatment of degenerative lumbar disease.. Arch Orthop Trauma Surg 2011 Sep;131(9):1239-45.
            pubmed: 21547697doi: 10.1007/s00402-011-1292-7google scholar: lookup
          11. Steffee AD, Sitkowski DJ. Posterior lumbar interbody fusion and plates.. Clin Orthop Relat Res 1988 Feb;227:99-102.
            pubmed: 3338227
          12. Brodke DS, Dick JC, Kunz DN, McCabe R, Zdeblick TA. Posterior lumbar interbody fusion. A biomechanical comparison, including a new threaded cage.. Spine (Phila Pa 1976) 1997 Jan 1;22(1):26-31.
            pubmed: 9122778doi: 10.1097/00007632-199701010-00005google scholar: lookup
          13. Weiner BK, Fraser RD. Spine update lumbar interbody cages.. Spine (Phila Pa 1976) 1998 Mar 1;23(5):634-40.
            pubmed: 9530797doi: 10.1097/00007632-199803010-00020google scholar: lookup
          14. Harms JG, Jeszenszky D. Die posteriore, lumbale, interkorporelle Fusion in unilateraler transforaminaler Technik.. Oper Orthop Traumatol 1998 Jun;10(2):90-102.
            pubmed: 17332991doi: 10.1007/s00064-006-0112-7google scholar: lookup
          15. Jang JS, Lee SH. Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation.. J Neurosurg Spine 2005 Sep;3(3):218-23.
            pubmed: 16235705doi: 10.3171/spi.2005.3.3.0218google scholar: lookup
          16. Ray CD. Threaded titanium cages for lumbar interbody fusions.. Spine (Phila Pa 1976) 1997 Mar 15;22(6):667-79; discussion 679-80.
            pubmed: 9089940doi: 10.1097/00007632-199703150-00019google scholar: lookup
          17. Peng CW, Yue WM, Poh SY, Yeo W, Tan SB. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion.. Spine (Phila Pa 1976) 2009 Jun 1;34(13):1385-9.
            pubmed: 19478658doi: 10.1097/BRS.0b013e3181a4e3begoogle scholar: lookup
          18. Resnick DK, Choudhri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC 3rd, Wang J, Walters BC, Hadley MN. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: lumbar fusion for disc herniation and radiculopathy.. J Neurosurg Spine 2005 Jun;2(6):673-8.
            pubmed: 16028736doi: 10.3171/spi.2005.2.6.0673google scholar: lookup
          19. Davis H. Increasing rates of cervical and lumbar spine surgery in the United States, 1979-1990.. Spine (Phila Pa 1976) 1994 May 15;19(10):1117-23; discussion 1123-4.
            pubmed: 8059266doi: 10.1097/00007632-199405001-00003google scholar: lookup
          20. Wang JC, Mummaneni PV, Haid RW. Current treatment strategies for the painful lumbar motion segment: posterolateral fusion versus interbody fusion.. Spine (Phila Pa 1976) 2005 Aug 15;30(16 Suppl):S33-43.
            pubmed: 16103832doi: 10.1097/01.brs.0000174559.13749.83google scholar: lookup
          21. Schwender JD, Holly LT, Rouben DP, Foley KT. Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results.. J Spinal Disord Tech 2005 Feb;18 Suppl:S1-6.
            pubmed: 15699793doi: 10.1097/01.bsd.0000132291.50455.d0google scholar: lookup
          22. Brantigan JW, McAfee PC, Cunningham BW, Wang H, Orbegoso CM. Interbody lumbar fusion using a carbon fiber cage implant versus allograft bone. An investigational study in the Spanish goat.. Spine (Phila Pa 1976) 1994 Jul 1;19(13):1436-44.
            pubmed: 7939971doi: 10.1097/00007632-199407000-00002google scholar: lookup
          23. CLOWARD RB. The treatment of ruptured lumbar intervertebral disc by vertebral body fusion. III. Method of use of banked bone.. Ann Surg 1952 Dec;136(6):987-92.
            pubmed: 12986683doi: 10.1097/00000658-195212000-00011google scholar: lookup
          24. Wiltse LL, Bateman JG, Hutchinson RH, Nelson WE. The paraspinal sacrospinalis-splitting approach to the lumbar spine.. J Bone Joint Surg Am 1968 Jul;50(5):919-26.
            pubmed: 5676831
          25. Humphreys SC, Hodges SD, Patwardhan AG, Eck JC, Murphy RB, Covington LA. Comparison of posterior and transforaminal approaches to lumbar interbody fusion.. Spine (Phila Pa 1976) 2001 Mar 1;26(5):567-71.
            pubmed: 11242386doi: 10.1097/00007632-200103010-00023google scholar: lookup
          26. KING D. Internal fixation for lumbosacral fusion.. J Bone Joint Surg Am 1948 Jul;30A(3):560-5.
            pubmed: 18109577
          27. WATKINS MB. Posterolateral bonegrafting for fusion of the lumbar and lumbosacral spine.. J Bone Joint Surg Am 1959 Apr;41-A(3):388-96.
            pubmed: 13641289
          28. Harrington PR. Instrumentation in spine instability other than scoliosis.. S Afr J Surg 1967 Jan-Mar;5(1):7-12.
            pubmed: 6044753
          29. Kambin P. Re: Foley KT, Holly LT, Schwender JD. Minimally invasive lumbar fusion. Spine 2003;28:S26-35.. Spine (Phila Pa 1976) 2004 Mar 1;29(5):598-9.
            pubmed: 15129085doi: 10.1097/01.brs.0000112066.78935.74google scholar: lookup
          30. Bagby GW. Arthrodesis by the distraction-compression method using a stainless steel implant.. Orthopedics 1988 Jun;11(6):931-4.
            pubmed: 3387340doi: 10.3928/0147-7447-19880601-13google scholar: lookup
          31. Brantigan JW, Neidre A, Toohey JS. The Lumbar I/F Cage for posterior lumbar interbody fusion with the variable screw placement system: 10-year results of a Food and Drug Administration clinical trial.. Spine J 2004 Nov-Dec;4(6):681-8.
            pubmed: 15541703doi: 10.1016/j.spinee.2004.05.253google scholar: lookup
          32. Hadra BE. The classic: Wiring of the vertebrae as a means of immobilization in fracture and Potts' disease. Berthold E. Hadra. Med Times and Register, Vol22, May 23, 1891.. Clin Orthop Relat Res 1975 Oct;(112):4-8.
            pubmed: 1104237
          33. WATKINS MB. Posterolateral fusion of the lumbar and lumbosacral spine.. J Bone Joint Surg Am 1953 Oct;35-A(4):1014-8.
            pubmed: 13108907
          34. Cloward RB. Posterior lumbar interbody fusion updated.. Clin Orthop Relat Res 1985 Mar;(193):16-9.
            pubmed: 3971616
          35. CLOWARD RB. The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I. Indications, operative technique, after care.. J Neurosurg 1953 Mar;10(2):154-68.
            pubmed: 13035484doi: 10.3171/jns.1953.10.2.0154google scholar: lookup
          36. O'Brien JP, Dawson MH, Heard CW, Momberger G, Speck G, Weatherly CR. Simultaneous combined anterior and posterior fusion. A surgical solution for failed spinal surgery with a brief review of the first 150 patients.. Clin Orthop Relat Res 1986 Feb;(203):191-5.
            pubmed: 2937594
          37. Taneichi H, Suda K, Kajino T, Matsumura A, Moridaira H, Kaneda K. Unilateral transforaminal lumbar interbody fusion and bilateral anterior-column fixation with two Brantigan I/F cages per level: clinical outcomes during a minimum 2-year follow-up period.. J Neurosurg Spine 2006 Mar;4(3):198-205.
            pubmed: 16572618doi: 10.3171/spi.2006.4.3.198google scholar: lookup
          38. Steffen T, Tsantrizos A, Fruth I, Aebi M. Cages: designs and concepts.. Eur Spine J 2000 Feb;9 Suppl 1(Suppl 1):S89-94.
            pubmed: 10766063doi: 10.1007/pl00010027google scholar: lookup
          39. Gelalis ID, Kang JD. Thoracic and lumbar fusions for degenerative disorders: rationale for selecting the appropriate fusion techniques.. Orthop Clin North Am 1998 Oct;29(4):829-42.
            pubmed: 9756975doi: 10.1016/s0030-5898(05)70051-1google scholar: lookup
          40. Kuslich SD, Ulstrom CL, Griffith SL, Ahern JW, Dowdle JD. The Bagby and Kuslich method of lumbar interbody fusion. History, techniques, and 2-year follow-up results of a United States prospective, multicenter trial.. Spine (Phila Pa 1976) 1998 Jun 1;23(11):1267-78; discussion 1279.
            pubmed: 9636981doi: 10.1097/00007632-199806010-00019google scholar: lookup
          41. Tajima N, Chosa E, Watanabe S. Posterolateral lumbar fusion.. J Orthop Sci 2004;9(3):327-33.
            pubmed: 15168193doi: 10.1007/s00776-004-0773-8google scholar: lookup
          42. Brantigan JW, Steffee AD, Geiger JM. A carbon fiber implant to aid interbody lumbar fusion. Mechanical testing.. Spine (Phila Pa 1976) 1991 Jun;16(6 Suppl):S277-82.
            pubmed: 1862425doi: 10.1097/00007632-199106001-00020google scholar: lookup
          43. Freeman BJ, Licina P, Mehdian SH. Posterior lumbar interbody fusion combined with instrumented postero-lateral fusion: 5-year results in 60 patients.. Eur Spine J 2000 Feb;9(1):42-6.
            pubmed: 10766076doi: 10.1007/s005860050007google scholar: lookup

          Citations

          This article has been cited 4 times.
          1. Prabhu MC, Jacob KC, Patel MR, Pawlowski H, Vanjani NN, Singh K. History and Evolution of the Minimally Invasive Transforaminal Lumbar Interbody Fusion. Neurospine 2022 Sep;19(3):479-491.
            doi: 10.14245/ns.2244122.061pubmed: 36203277google scholar: lookup
          2. Matos TD, Fleury RBC, Teixeira KO, Romero V, Defino HLA. CHANGES IN THE LUMBAR VERTEBRAL SEGMENT RELATED TO THE CAGE POSITION IN TLIF TECHNIQUE. Acta Ortop Bras 2020 Mar-Apr;28(2):92-96.
            doi: 10.1590/1413-785220202802224215pubmed: 32425672google scholar: lookup
          3. Krieg SM, Meyer B. [Operative options for failed back surgery syndrome]. Orthopade 2016 Sep;45(9):732-7.
            doi: 10.1007/s00132-016-3309-ypubmed: 27541352google scholar: lookup
          4. Li Y, Su T, Meng T, Song D, Yin H. The fusion rates at different times of cortical iliac crest autograft or allograft compared with cages after anterior cervical discectomy and fusion: a meta-analysis. Eur Spine J 2024 Mar;33(3):1148-1163.
            doi: 10.1007/s00586-023-08118-0pubmed: 38319436google scholar: lookup
          Subscribe to our newsletter
          Join 99,780 horse owners like you who receive our email updates on horse health and nutrition.