Open AccessEvolution of Design of Interbody Cages for Anterior Lumbar Interbody Fusion
Author(s) -
Phan Kevin,
Mobbs Ralph J
Publication year - 2016
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12259
Subject(s) - medicine , degenerative disc disease , cage , lumbar , surgery , spondylolisthesis , fixation (population genetics) , low back pain , population , mathematics , environmental health , combinatorics , alternative medicine , pathology
Anterior lumbar interbody fusion ( ALIF ) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low‐grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes. The increasing popularity of ALIF is reflected by the increasing abundance of published studies reporting clinical outcomes, surgical techniques and grafting options for ALIF . Developments in cage designs include cylindrical Bagby and Kuslich , cylindrical ray, cylindrical mesh, lumbar‐tapered, polyethyl‐etherketone cage and integral fixation cages. Biologic implants include bone dowels and femoral ring allografts. Methods for optimization of cage design have included cage dimensions, use of novel composite cage materials and integral fixation technologies. However, the historical development and evolution of cages used for ALIF has not been extensively documented. This article therefore aims to provide an overview of the historical basis for the anterior approach, evolution in design of ALIF cage implants and potential future research directions.