Hejrati Nader, Martens Benjamin, Jost Bernhard, Bozinov Oliver, Stienen Martin N
Spine Center of Eastern Switzerland, Cantonal Hospital of St. Gallen & Medical School of St. Gallen, Rorschacher Str. 95, St. Gallen, CH-9007, Switzerland.
Department of Neurosurgery, Cantonal Hospital of St. Gallen & Medical School of St. Gallen, Rorschacher Str. 95, St. Gallen, CH-9007, Switzerland.
Eur Spine J. 2025 Jan;34(1):182-190. doi: 10.1007/s00586-024-08539-5. Epub 2024 Oct 26.
To report on the failure rates of an expandable interbody spacer, used for spinal instrumented transforaminal lumbar interbody fusion (TLIF) or posterior thoracolumbar interbody fusion (PLIF).
In this retrospective, single-center observational cohort study we reviewed consecutive PLIF/TLIF patients using the Catalyft™ PL and PL40 expandable titanium interbody implant (Medtronic, Minneapolis (USA)) between 07/2022 and 11/2023. We recorded patient demographics, surgical parameters, adverse events, radiological parameters and clinical outcomes according to the MacNab criteria.
We identified 53 patients (mean age 68.6 ± 11.5 years; 49.1% female; mean BMI 25.7 ± 4.4 kg/m), in which 92 Catalyft™ spacers were implanted, mostly at L4/5 (n = 35; 38.0%) and L5/S1 (n = 31; 33.7%) for degenerative (n = 44; 83.0%), deformity (n = 7; 13.2%) or other indications (n = 2; 3.8%). We noticed secondary collapse of 20 (21.7%) spacers in 11 patients (20.7%) occurring after a mean time of 4.0 ± 4.1 months postoperatively. Age < 70 years was identified as risk factor for secondary collapse (OR 3.71, 95% CI 1.31-10.5, p = 0.014), but no association was found regarding other patient-specific or surgery-related variables. Pseudarthrosis was evident in seven patients (13.2%), of which four (7.6%) required revision surgery. Clinical outcome at last follow-up (mean 6.4 ± 4.2 months) was excellent/good in 29 (54.7%), fair in 14 (26.4%) and poor in six patients (11.3%).
We provide a critical analysis of our series of patients with use of a specific type of expandable interbody spacer. We noticed failure and secondary collapse in an unacceptably high number of implants, some of which required revision surgery.
报告一种用于脊柱器械辅助经椎间孔腰椎椎间融合术（TLIF）或胸腰椎后路椎间融合术（PLIF）的可扩张椎间融合器的失败率。
在这项回顾性单中心观察性队列研究中，我们回顾了2022年7月至2023年11月期间连续使用Catalyft™ PL和PL40可扩张钛椎间植入物（美敦力公司，美国明尼阿波利斯）进行PLIF/TLIF手术的患者。我们根据MacNab标准记录了患者的人口统计学资料、手术参数、不良事件、放射学参数和临床结果。
我们确定了53例患者（平均年龄68.6±11.5岁；49.1%为女性；平均BMI为25.7±4.4kg/m²），共植入了92个Catalyft™ 融合器，主要用于L4/5（n = 35；38.0%）和L5/S1（n = 31；33.7%）节段，用于退行性病变（n = 44；83.0%）、畸形（n = 7；13.2%）或其他适应症（n = 2；3.8%）。我们注意到11例患者（20.7%）中的20个（21.7%）融合器出现继发性塌陷，平均发生在术后4.0±4.1个月。年龄<70岁被确定为继发性塌陷的危险因素（OR 3.71，95%CI 1.31-10.5，p = 0.014），但未发现与其他患者特异性或手术相关变量存在关联。7例患者（13.2%）出现假关节形成，其中4例（7.6%）需要翻修手术。最后一次随访时（平均6.4±4.2个月）的临床结果为优/良的有29例（54.7%），中等的有14例（26.4%），差的有6例（11.3%）。
我们对使用特定类型可扩张椎间融合器的一系列患者进行了批判性分析。我们注意到大量植入物出现失败和继发性塌陷，其中一些需要翻修手术。
