Introduction The concept of creating a fusion between two vertebral bodies as a solution to pain arising from lumbar spinal segments dates back to the 1930s when the first anterior lumbar interbody fusion (ALIF) was performed, using an autogenous tibial…
Introduction There are many factors to consider in determining if a staged anterior-posterior (AP) lumbar procedure is the most appropriate for a given patient. These include the patient’s presenting symptoms (i.e., discogenic back pain, radiculopathy, myelopathy), bone quality, age, performance…
Introduction An exponential rise in rates of spinal surgery over the past decade has been dominated by a concomitant increase in the utilization of intervertebral cages for spinal fusion. The modernized minimally invasive retroperitoneal transpsoas approach for lateral lumbar interbody…
Introduction Degenerative disease of the lumbar spine has increased with the aging population and the number of elective lumbar spinal surgeries has also increased. Concurrently, the number of revision lumbar spinal surgeries has also increased as patients experience recurrence of…
Introduction In 1969 and 1971, Coventry and Stauffer provided the first descriptions of anterior fusion for the treatment of failed posterior spine surgery, reporting overall good results. Since then, anterior lumbar interbody fusion (ALIF) has been used to treat a…
Introduction Revision surgeries are more common than ever in the spine surgeon’s practice. Each case is unique, and the diagnostic and treatment considerations are more complicated than their primary counterparts. In general, revision surgeries involve greater morbidity than primary surgeries,…
The Use of Autograft and Allograft in Revision Lumbar Spine Surgery One of the major contributors to a solid spinal arthrodesis is the use of bone grafts. In selecting the appropriate graft, there are three properties that receive consideration: osteoinductivity,…
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Introduction Lumbar intervertebral discs are complex structures subjected to significant axial compressive forces. Because of biomechanical demands and the inability to remodel as a result of an avascular nature, lumbar disc herniation (LDH) is a relatively common cause of back…
Introduction Lumbar spine disorders and the disabling pain associated with these conditions are associated with significant healthcare resource use and costs in the United States. Of these patients, an estimated 3% with back pain will require surgical intervention. Spine surgery…