Long Term Follow Up Of Posterior Lumbar Interbody Fusion Using The Ray Threaded Fusion Cage.

From: Helen Dynda (olddad66@runestone.net)
Sun Oct 28 15:31:43 2001


[] Long Term Follow Up Of Posterior Lumbar Interbody Fusion Using The RAY THREADED FUSION CAGE™ - Case Review

http://www.surgicaldynamics.com/spine/case_index.html

This patient is a 57 year old white female who first experienced lower back pain in 1983 after a compression/torsion strain to the lumbar spine. Her past medical history includes cholecystectomy, appendectomy, and breast reduction. She does not use alcohol or cigarettes.

On 7/19/91, a lumbar CT showed a disc bulge at L4-L5 with sclerotic changes in the end plates and facets. A lateral recess stenosis was also indicated. Lumbar spine films showed marked narrowing at the L4-L5 interspace. The patient was initially diagnosed with lumbar spondylosis and spinal stenosis at L4-L5, and given recommendations to undertake weight loss and abdominal and lumbar strengthening exercises.

On 12/1/91, lumbar spine films showed moderately prominent degenerative disc disease and prominent degenerative facet arthropathy at L4-L5 with disc narrowing, along with end plate sclerosis and osteophytes.

On 1/13/92, the patient underwent L4-L5 laminotomy, radical discectomy, and posterior lumbar interbody fusion using two Ray TFC devices containing bone graft harvested from the left iliac crest. The follow up visit on 1/23/92 showed a well healed incision. There was no motor, sensory, or reflex deficit present.

On 2/25/92, the patient returned for a follow up visit, reporting a pain level of 5 out of 10 after periods of sitting up to four hours. The preoperative pain level was 10. There was no motor,sensory, or reflex deficit noted in the lower extremities.

On 1/28/93, the lumbar spine films of the patient that were taken showed no evidence of radiolucent halo or bone sclerosis around the implant, measured on the lateral view. The disc height was measured at 9 millimeters. The A/P view indicated increased or maintained bony density within the Ray TFC devices.

On 10/29/96, the office exam and x-ray follow up showed overall improvement, positive evidence of fusion at the operative level, and no motor, sensory, or reflex deficit.

On 10/29/97, the lumbar spine films of the patient that were taken showed a stable fusion with no radiolucency or sclerosis.

The patient returned on 3/9/00 for a follow up office visit. The attached four view lumbar spine x-rays with obliques (are pictured at the above web site) were performed and showed no change in Ray TFC device placement at L4-L5.


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