Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR) during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF) surgery was compared to the corre...

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Autores principales:	Kleiner JB, Kleiner HM, Grimberg Jr EJ, Throlson SJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	T-LIF diskectomy bone graft lumbar fusion minimally invasive spinal surgery. Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/482cd3b6d4f249eaadd8b5813ffaaa7b
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spelling	oai:doaj.org-article:482cd3b6d4f249eaadd8b5813ffaaa7b2021-12-02T00:54:23ZEvaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion1179-1470https://doaj.org/article/482cd3b6d4f249eaadd8b5813ffaaa7b2016-05-01T00:00:00Zhttps://www.dovepress.com/evaluation-of-a-novel-tool-for-bone-graft-delivery-in-minimally-invasi-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR) during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF) surgery was compared to the corresponding bone graft (BG) volumes inserted at the time of fusion. A novel BG delivery tool (BGDT) was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD). This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk relative to AD. Keywords: T-LIF, diskectomy, bone graft, lumbar fusion, minimally invasive spinal surgery, pseudoarthrosisKleiner JBKleiner HMGrimberg Jr EJThrolson SJDove Medical PressarticleT-LIFdiskectomybone graftlumbar fusionminimally invasive spinal surgery.Medical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2016, Iss Issue 1, Pp 105-114 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	T-LIF diskectomy bone graft lumbar fusion minimally invasive spinal surgery. Medical technology R855-855.5
spellingShingle	T-LIF diskectomy bone graft lumbar fusion minimally invasive spinal surgery. Medical technology R855-855.5 Kleiner JB Kleiner HM Grimberg Jr EJ Throlson SJ Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
description	Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR) during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF) surgery was compared to the corresponding bone graft (BG) volumes inserted at the time of fusion. A novel BG delivery tool (BGDT) was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD). This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk relative to AD. Keywords: T-LIF, diskectomy, bone graft, lumbar fusion, minimally invasive spinal surgery, pseudoarthrosis
format	article
author	Kleiner JB Kleiner HM Grimberg Jr EJ Throlson SJ
author_facet	Kleiner JB Kleiner HM Grimberg Jr EJ Throlson SJ
author_sort	Kleiner JB
title	Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
title_short	Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
title_full	Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
title_fullStr	Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
title_full_unstemmed	Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
title_sort	evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/482cd3b6d4f249eaadd8b5813ffaaa7b
work_keys_str_mv	AT kleinerjb evaluationofanoveltoolforbonegraftdeliveryinminimallyinvasivetransforaminallumbarinterbodyfusion AT kleinerhm evaluationofanoveltoolforbonegraftdeliveryinminimallyinvasivetransforaminallumbarinterbodyfusion AT grimbergjrej evaluationofanoveltoolforbonegraftdeliveryinminimallyinvasivetransforaminallumbarinterbodyfusion AT throlsonsj evaluationofanoveltoolforbonegraftdeliveryinminimallyinvasivetransforaminallumbarinterbodyfusion
_version_	1718403434884890624

Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

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