[Clinical application of interbody cage systems in the lumbar spine].

OBJECTIVE

To study the clinical value of interbody cage systems in the surgical treatment of unstable lumbar segment, and evaluate the biomechanical properties.

METHODS

Ninety-seven cases were selected for operation by posterior lumbar interbody fusion with the BAK-cage or TFC device. Of the patients, 18 were diagnosed as lumbar disc degeneration disease (DDD), 37 as lumbar stenosis, 23 as spondylolisthesis, and 19 as unstable traumatic lesion. Thirty-six of them received additional posterior pedicle devices; 13 cases with severe mechanical back pain underwent anterior interbody fusion with the BAK-cage or TFC or interbod spacer, 4 of them underwent surgery once again. A new anterior Mesh-cage was used in spinal reconstruction for some patients, including 8 patients with thoracolumbar tumor, 2 with lumbar burst fracture, and 1 with osteoportic late collapse of a vertebral body.

RESULTS

In the follow-up for an average of 21 months, 63 patients were available for review. The clinical results were excellent and good in 91.2% of the patients who underwent posterior interbody cage fusion; the preoperative percentage of slip was corrected in 89% of the patients with spondlyolithsis and in 100% of the patients with traumatic dislocation. The satisfactory rate was 94.6% in the patients with severe back pain who underwent anterior interbody cage fusion. The rate of union in the grafted area was 95% at the 6th month after the operation. A preliminary experience showed that the clinical effect was obvious as the Mesh-cage was used in the patients with tumor, symptoms were relieved and motion ability was greatly improved in these patients.

CONCLUSION

The interbody cage implant produces immediate stabilisation on unstable spinal segments, offers a conductive biomechanical environment for interbody graft healing by distraction properties and weight bearing function, and restores the normal interbody space and spinal column lordosis with satisfactory clinical effects on such diseases as DDD, traumatic lesion, osteoporotic late collapse of a vertebral body and spinal tumors.