title: Combination Ti/PEEK ALIF cage for anterior lumbar interbody fusion: Early clinical and radiological results.
abstract: Anterior lumbar interbody fusion (ALIF) is a common procedure for patients with degenerative pathologies of the lumbar spine. In this study, the clinical and radiological outcomes of a combination titanium/polyetheretherketone (Ti/PEEK) ALIF cages in one, two and three-level surgery were evaluated. Over an 18-month time period, a prospective single surgeon series of 20 implants (15 patients) were included in the study, with minimum 10-months follow-up. From these 15 patients, two were supplemented with posterior percutaneous pedicle screw fixation for additional stability. Radiological follow-up with fine cut CT scan at 9-12months was performed to evaluate early fusion rates, and integration of the Titanium/PEEK cage at the endplate junction. 20 implants were followed for a minimum of 10months, and a mean of 15months. A 95% (19/20 implants) fusion rate with no implant related complications was achieved at the mean 15-month postoperative mark. Patients experienced statistically significant improvement in pain and functional outcomes (SF12 and ODI) compared to their pre-operative status. A single patient with a non-union at L5/S1 (smoker) did not experience any improvement in symptoms. A Ti-PEEK cage, with allograft and BMP-2 to achieve interbody fusion is an effective implant for use in anterior lumbar surgery with high fusion rates, no lucency around the titanium endplates at follow-up, and with promising early results.
authors.affiliation: University of New South Wales (UNSW), Sydney, Australia; Department of Spine Surgery, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia. Electronic address: ralphmobbs@hotmail.com.
authors.forename: Ralph Jasper
authors.initials: RJ
authors.lastname: Mobbs
authors.affiliation: University of New South Wales (UNSW), Sydney, Australia; NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Phan
authors.affiliation: University of New South Wales (UNSW), Sydney, Australia; NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, Australia.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Assem
authors.affiliation: NeuroSpine Surgery Research Group (NSURG), Prince of Wales Private Hospital, Randwick, Australia; Surgical & Orthopaedic Research Laboratories Level 1, Prince of Wales Hospital, Randwick, Sydney, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Pelletier
authors.affiliation: Surgical & Orthopaedic Research Laboratories Level 1, Prince of Wales Hospital, Randwick, Sydney, Australia.
authors.forename: William R
authors.initials: WR
authors.lastname: Walsh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001577:Benzophenones; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007659:Ketones / Q000737:chemistry*; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011092:Polyethylene Glycols / Q000737:chemistry*; D011108:Polymers; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D019736:Prostheses and Implants; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium
keywords: ALIF; Biphasic calcium phosphate; PEEK; Synthetic graft; Titanium