ABSTRACT
We reviewed the medical files of 32 patients with degenerative disc disease, spinal stenosis, and spondylolisthesis who underwent posterior lumbar interbody fusion using the B-Twin system. In 12 of these patients, posterior lumbar interbody fusion has been supplemented with posterior lumbar-instrumented fusion (circumferential fusion) because of spinal instability. Clinical and functional outcomes were assessed. The quality of fusion and disc height were recorded. The mean follow-up was 36 months (range, 18 to 42 months). At the latest examination, clinical improvement and fusion were statistically significant in both groups; the mean Oswestry disability index improved from 55% to 24%, and to 22% in the patients with more than 20 months follow-up; the mean Rolland-Morris disability questionnaire improved from 52% to 29% (p < 0.001); 95.6% (22/23) of the levels managed with the B-Twin system alone and 92.9% (13/14) of the levels managed with circumferential fusion showed solid fusion; and the intervertebral disc height increased from 8.1 +/- 0.74 mm to 11.4 +/- 0.93 mm in the B-Twin group and from 7.7 +/- 0.75 mm to 10.6 +/- 0.91 mm in the circumferential fusion group. However, in comparing the two groups there was no statistical significant difference. The B-Twin system is safe and effective for the management of degenerative disc disease as a stand-alone device. The combination with posterior lumbar-instrumented fusion systems for circumferential fusion yields statistically significant differences in fusion rate and functional outcome.
Subject(s)
Intervertebral Disc Displacement/diagnostic imaging , Intervertebral Disc Displacement/surgery , Spinal Fusion/methods , Spinal Stenosis/surgery , Spondylolisthesis/surgery , Adult , Aged , Female , Humans , Intervertebral Disc Displacement/complications , Low Back Pain/etiology , Lumbar Vertebrae/diagnostic imaging , Male , Medical Records , Middle Aged , Postoperative Period , Radiography , Retrospective StudiesABSTRACT
Biologic resurfacing of the glenoid is a treatment alternative for young patients who develop rapid and aggressive destruction of glenoid. In 2001, a technique was developed to allow secure fixation of a meniscal allograft to the glenoid in combination with hemi-arthroplasty replacement of the humeral head. The authors have modified this technique by addressing posterior wear factors, as well as circumferential covering of the glenoid perimeter. The meniscal horns are sutured together to fashion the allograft in an ovoid shape. The meniscus closely matches the circumference of the glenoid and therefore 180 degrees coverage of the glenoid rim is achieved. In addition, the wedge shape of the meniscus may enhance comfort and stability.
