Intervertebral cages in the treatment of lumbar disc disease.
Background. There are many surgical techniques for the application of intervertebral cages: anterior approach, laparoscopy, posterior approach. This article presents a review of the literature and describes the authors' own experience. The results obtained with these techniques vary but are generally positive. The number of complications is approximately the same as in traditional methods of intervertebral spondylodesis using bone grafts. Material and methods. At the Orthopedics and Rehabilitation Clinic of the Jagiellonian University College of Medicine in Zakopane between 2000 and 2003 we installed 130 cages in 119 patients. We distinguished 2 groups: 51 patients with acute discopathy and no improvement after conservative treatment, and 65 patients with degenerative discopathy. The age range was 15-17 (mean 42), 57 women, 62 men. All patients were operated from the posterior approach (PLIF). Results. There were complications in 11 cases (9.24%), most often caused by withdrawal of the titanium cage to the interior of the spinal canal, due to a surgical error, consisting in not implanting the cage deeply enough in the intervertebral space, impacted on the upper or lower elastic layer. All these patients had to be re-operated to improve cage placement or replace it, most often with another model. Rupture of the durum was repaired by suture and surgical glue. Conclusions. Intervertebral spondylodesis with cages is a useful surgical method that gives good outcome; however, their implantation requires proper qualification of the patient for surgery and a properly trained surgical team.
Daniel
D
Zarzycki
Paweł
P
Radło