Instrumented spinal arthrodesis

Instrumented spinal arthrodesis using rigid rods is currently the most widely used treatment for degenerative diseases of the lumbar spine, particularly if unresponsive to conservative care. However, the elastic modulus of titanium, the main metallic material used in lumbar fusion procedures, is much greater than that of bone, which may significantly change the physiological distribution of the load at the instrumented vertebral segments 1) 2) 3)

Reduction, when accomplished in conjunction with wide neural element decompression and instrumented arthrodesis, is safe, effective, and durable with low rates of neurologic injury, favorable clinical results, and high fusion rates 4).

1)
Kurtz SM, Devine JN. PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials. 2007;28(32):4845–4869.
2)
Narayan P, Haid RW, Subach BR, Comey CH, Rodts GE. Effect of spinal disease on successful arthrodesis in lumbar pedicle screw fixation. J. Neurosurg. 2002;97(3 Suppl):277–280.
3)
Ponnappan RK, Serhan H, Zarda B, Patel R, Albert T, Vaccaro AR. Biomechanical evaluation and comparison of polyetheretherketone rod system to traditional titanium rod fixation. Spine J. 2009;9(3):263–267.
4)
Gandhoke GS, Kasliwal MK, Smith JS, Nieto J, Ibrahimi D, Park P, Lamarca F, Shaffrey C, Okonkwo DO, Kanter AS. A Multi-Center Evaluation of Clinical and Radiographic Outcomes Following High-Grade Spondylolisthesis Reduction and Fusion. J Spinal Disord Tech. 2014 Oct 31. [Epub ahead of print] PubMed PMID: 25361435.