Quantative Intra-operative Disc Volume Measurement to Provide Guidelines for Spinal Fusion Surgery

Abstract

Spinal fusion surgery has shown to be an effective treatment of lumbar instability, deformity, and debilitating lower back pain when unresponsive to non-surgical techniques. Spinal interbody fusion involves the removal of the intervertebral disc and scraping of the bony endplates to promote fusion of the vertebrae across the disc section after cages or screws are inserted. The most common techniques for interbody fusion include: Anterior Lumbar Interbody Fusion (ALIF) and Transforaminal Lumbar Interbody Fusion (TLIF). For these procedures, in vitro models have shown that disc removal greater than 30% is needed to promote fusion supporting loads greater than 600N. Unfortunately, no clinical validation exists comparing disc volume removed to clinical outcomes. The objective of this study was to identify the relationship between the percentage of disc material removed intra-operatively and clinical outcomes for interbody fusion procedures.