A Multi-center Clinical Study of Posterior Lumbar Interbody Fusion with the Expandable Stand-alone Cage (Tyche(R) Cage) for Degenerative Lumbar Spinal Disorders. |
Jin Wook Kim, Hyung Chun Park, Seung Hwan Yoon, Seong Hoon Oh, Sung Woo Roh, Dae Cheol Rim, Tae Sung Kim |
1Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea. phchun@inha.ac.kr 2Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Korea. 3Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. 4Department of Neurosurgery, College of Medicine, Hallym University, Seoul, Korea. 5Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea. |
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ABSTRACT |
OBJECTIVE This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage (Tyche(R) cage) for degenerative spinal diseases during the same period in each hospital. METHODS Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. RESULTS The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as 9.94+/-2.69 mm before surgery was increased to 12.23+/-3.31 mm at postoperative 1 month and was stabilized at 11.43+/-2.23 mm on final visit. The segmental angle of lordosis was changed significantly from 3.54+/-3.70 degrees before surgery to 6.37+/-3.97 degrees by 24 months postoperative, and total lumbar lordosis was 20.37+/-11.30 degrees preoperatively and 24.71+/-11.70 degrees at 24 months postoperative. CONCLUSION The re have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success. |
Key Words:
Expandable cage; Degeneration; Interbody fusion; Lumbar spine |
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