Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/6859
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Type: Journal article
Title: Radiologic assessment of interbody fusion using carbon fiber cages
Author: Santos, E.
Goss, D.
Morcom, R.
Fraser, R.
Citation: Spine, 2003; 28(10):997-1001
Publisher: Lippincott Williams & Wilkins
Issue Date: 2003
ISSN: 0362-2436
1528-1159
Statement of
Responsibility: 
Santos, Edward R. G. ; Goss, David G. MD; Morcom, Russel K.; Fraser, Robert D.
Abstract: STUDY DESIGN: A comparative study investigated the use of plain static radiographs, flexion-extension radiographs, and thin-section helical computed tomography (CT) scanning in the assessment of anterior lumbar interbody fusion using carbon fiber cages. OBJECTIVE: To compare plain static radiographs, flexion-extension radiographs, and thin-section helical computed tomography scans in the assessment of lumbar interbody fusion using carbon fiber cages. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion has become a popular procedure for the treatment of discogenic back pain. However, there currently is no universally accepted radiologic assessment tool for determining fusion, and the definitive criteria for diagnosing a successful interbody fusion in the lumbar spine remains controversial. METHODS: Plain static radiographs, flexion-extension radiographs, and helical computed tomography scans were performed on 32 patients (49 levels) 5 years after anterior lumbar interbody fusion using carbon fiber cages and autologous bone. A radiologist assessed fusion using the Hutter method to detect movement, whereas a spinal surgeon measured movement in degrees using the Simmons method. Helical computed tomography scans were assessed for the presence of bridging trabecular bone. RESULTS: The fusion rate was 86% on plain radiographs and 84% with the Hutter method. The fusion rate was 74% with the 2 degrees cutoff, and 96% with the 5 degrees cutoff prescribed by the Food and Drug Administration. Fusion on helical computed tomography scans was observed in 65% of the patients. CONCLUSIONS: In the radiologic assessment of interbody fusion using carbon fiber cages, the use of plain radiographs and flexion-extension radiographs produced much higher fusion rates than assessment with thin-section helical computed tomography scans. The thin-section helical computed tomography studies clearly demonstrated the radiographic presence or absence of bridging bone, a property that was not seen with plain static radiographs or flexion-extension radiographs.
Keywords: Lumbar Vertebrae; Humans; Tomography, Spiral Computed; Spinal Fusion; Sensitivity and Specificity; Adult; Aged; Middle Aged; Female; Male
RMID: 0020030601
DOI: 10.1097/01.BRS.0000061988.93175.74
Appears in Collections:Orthopaedics and Trauma publications

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