Skip to main content
SpringerLink
Log in

Fusion Techniques for Degenerative Disease

  • Chapter
Spinal Fusion

  • 265 Accesses

Abstract

The era of spinal fusion surgery began with the first reports of Hibbs and Albee in 1911.1,2 Since that time many types of fusion have been described, but the specific indications for performing fusion in the setting of degenerative disease have remained less well defined. Despite some more recent articles that have attempted to clarify the role of fusion in the treatment of degenerative spinal disease,3–11 there still exist areas of confusion regarding this controversial subject. The goal of this chapter is to provide a selection of recommended techniques of spinal fusion that may be used to stabilize the spine following degenerative disease. In addition, an attempt is made to describe what the authors believe are the indications for which spinal fusion should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Albee FH. Transplantation of a portion of the tibia for Pott’s disease. JAMA 1911;57:885–886.

    Google Scholar 

  2. Hibbs RA. An operation for progressive spinal deformities. NY State J Med 1911;93:1013–1016

    Google Scholar 

  3. Boumphrey FS. Fusion in the Lumbar Spine in Lumbar Disc Disease. New York: Raven Press: 1982:177–192.

    Google Scholar 

  4. Ehni G. The role of spine fusion: question 9. Spine 1981;6:308–310.

    Article  Google Scholar 

  5. Frymoyer JW. The role of spine fusion, question 3. Spine 1981;6:284–290.

    Article  Google Scholar 

  6. Frymoyer JW, Selby DK. Segmental instability: rationale for treatment. Spine 1985;10:280–286.

    Article  PubMed  CAS  Google Scholar 

  7. Lehmann TR, Spratt KF, Tozzi JE, Weinstein JN, Reinarz S J, El-Khoury GY, Colby H. Long-term follow-up of lower lumbar fusion patients. Spine 1987;12:97–104.

    Article  PubMed  CAS  Google Scholar 

  8. Lombardi JS, Wiltse LL, Reynolds J, Widell EH, Spineur C. The treatment of degenerative spondylolisthesis. Spine 1985;10:821–827.

    Article  PubMed  CAS  Google Scholar 

  9. Mooney V. Where is the pain coming from? Spine 1987;12:754–759.

    Article  PubMed  CAS  Google Scholar 

  10. Nachemson A. Towards a better understanding of low back pain. A review of the mechanics of the lumbar disc. Rheumatol Rehabil 1975;14:129–143.

    Article  PubMed  CAS  Google Scholar 

  11. Stokes IAF, Frymoyer JW. Segmental motion and instability. Spine 1987;12:688–691.

    Article  PubMed  CAS  Google Scholar 

  12. Bohlman HH. Cervical spondylosis with moderate to severe myelopathy. A report of seventeen cases treated by Robinson anterior cervical discectomy and fusion. Spine 1977;2:151–162.

    Article  Google Scholar 

  13. Gore DR, Sepie SB. Anterior cervical fusion for degenerated or protruded discs. A review of one hundred forty-six patients. Spine 1984;9:667–671.

    Article  PubMed  CAS  Google Scholar 

  14. Henderson CM, Hennessy RG, Shuey HM, Shackelford EG. Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery 1983;13:504–512.

    Article  PubMed  CAS  Google Scholar 

  15. Hodgson MB, Wong SK. A description of a technique and evaluation of results in anterior spinal fusion for deranged intervertebral disc and spondylolisthesis. Clin Orthop 1968;56:133–162.

    PubMed  CAS  Google Scholar 

  16. Lunsford LD, Bissonette DJ, Jannetta PJ, Sheptak PE, Zorub DS. Anterior surgery for cervical disc disease. Part I: Treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 1980;53:1–11.

    Article  PubMed  CAS  Google Scholar 

  17. Robinson RA, Walker AE, Ferlic DC, Wiecking DK. The results of anterior interbody fusion of the cervical spine. J Bone Joint Surg 1962;44A:1569–1587.

    Google Scholar 

  18. Spangfort EV. The lumbar disc herniation. A computer-aided analysis of 2,504 operations. Acta Orthop Scand (Suppl) 1972;142:1–95.

    CAS  Google Scholar 

  19. White AA, Southwick WO, DePonte RJ, Gainer JW, Hardy R. Relief of pain by anterior cervical fusion for spondylosis. J Bone Joint Surg 1973;55A:525.

    Google Scholar 

  20. Crock HV. Observations on the management of failed spinal operations. J Bone Joint Surg 1976;58B:193–199.

    Google Scholar 

  21. Flynn JC, Hogue MA. Anterior fusion of the lumbar spine. End-result study with long-term follow-up. J Bone Joint Surg 1979;61A:1143–1150.

    Google Scholar 

  22. Hirsch C. Efficiency of surgery in low back disorders. J Bone Joint Surg 1965;47A:991.

    Google Scholar 

  23. Stauffer RN, Coventry MB. Anterior interbody lumbar spine fusion, analysis of Mayo Clinic Series. J Bone Joint Surg 1972;54A:756–768.

    Google Scholar 

  24. Stauffer RN, Coventry MB. Posterolateral fusion of the lumbar and lumbosacral spine. J Bone Joint Surg 1972;54A:1195–1204.

    Google Scholar 

  25. Brooks AL, Jenkins EB. Atlantoaxial arthrodesis by the wedge compression method. J Bone Joint Surg 1978;60A:279–284.

    Google Scholar 

  26. Jones AAM, McAfee PC, Robinson RA, Zinreich SJ, Wang H. Failed arthrodesis of the spine for severe spondylolisthesis. Salvage by interbody arthrodesis. J Bone Joint Surg 1988;70A:25–30.

    Google Scholar 

  27. White AH, von Rogov P, Zucherman J, Heiden D. Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fixation fusion. Spine 1987;12:305–307.

    Article  PubMed  CAS  Google Scholar 

  28. Frymoyer JW, Newberg A, Wilder PG, Clements J, Mac-Pherson B. Spine radiographs in patients with low-back pain. J Bone Joint Surg 1984;66A:1048–1055.

    Google Scholar 

  29. Kellgren JH, Lawrence JS. Osteo-arthrosis and disc degeneration in an urban population. Ann Rheum Dis 1958;17:388–397.

    Article  PubMed  CAS  Google Scholar 

  30. Park WM. The place of radiology in the investigation of low back pain. Clin Rheum Dis 1980;6:93–132.

    Google Scholar 

  31. Bell GR, Rothman RH, Booth RE, Cuckler JM, Garfin S, Herkowitz H, Simeone FA, Dolinskas C, Hans SS. A study of computer-assisted tomography. II. Comparison of Metrizamide myelography and computed tomography in the diagnosis of herniated lumbar disc and spinal stenosis. Spine 1984;9:552–556.

    Article  PubMed  CAS  Google Scholar 

  32. Weisel SW, Tsourmes M, Feffer HL, Citrin CM, Patronas N. A Study of computer assisted tomography. The incidence of positive CAT scans in an asymptomatic group of patients. Spine 1984;9:549–551.

    Article  Google Scholar 

  33. Fielding JW, Cochran GVB, Lawsing JF, Hohl M. Tears of the transverse ligament of the atlas. J Bone Joint Surg 1974;56A:1683.

    Google Scholar 

  34. Fielding JW, Hawkins RJ, Ratzau SA. Spine fusion for atlanto-axial instability. J Bone Joint Surg 1976;58A:400.

    Google Scholar 

  35. White AA, Johnson RM, Panjabi MM, Southwick WO. Biochemical analysis of clinical stability in the cervical spine. Clin Orthop 1975;109:85.

    Article  PubMed  Google Scholar 

  36. Macnab I. The traction spur: an indication of segmental instability. J Bone Joint Surg 1971;53A:663–670.

    Google Scholar 

  37. Friberg O. Lumbar instability: a dynamic approach by traction-compression radiography. Spine 1987;12:119–129.

    Article  PubMed  CAS  Google Scholar 

  38. Dupuis PR, Yong-Hing K, Cassidy JD, Kirkaldy-Willis WH. Radiologic diagnosis of degenerative lumbar spinal instability. Spine 1985;10:262–276.

    Article  PubMed  CAS  Google Scholar 

  39. McAfee PC, Bohlman HH, Han JS, Salvagno RT. Comparison of nuclear magnetic resonance imaging and computed tomography in the diagnosis of upper cervical spinal cord compression. Spine 1986;11:295–304.

    Article  PubMed  CAS  Google Scholar 

  40. Modic MT, Masaryk T, Boumphrey F, Goormastic M, Bell G. Lumbar herniated disc disease and canal stenosis: prospective evaluation by surface coil MR, CT, and myelography. Am J Neuroradiol 1986;7:709–717.

    Google Scholar 

  41. Fon GT, Sage MR. Computed tomography in cervical disc disease when myelography is unsatisfactory. Clin Radiol 1984;35:47–50.

    Article  PubMed  CAS  Google Scholar 

  42. Masaryk T, Modic MT, Geisinger MA, et al. Cervical myelopathy: a comparison of magnetic resonance and conventional myelography. J Comput Assist Tomogr 1986; 10:184–194.

    Article  PubMed  CAS  Google Scholar 

  43. Modic MT, Masaryk TJ, Mulopulos GP, Bundschuh C, Han JS, Bohlman HH. Cervical radiculopathy: prospective evaluation with surface coil MR imaging, CT with metrizamide, and metrizamide myelography. Radiology 1986;161:753–759. Vol. 3, Dec 1986.

    PubMed  CAS  Google Scholar 

  44. Lunsford LD, Bissonette DJ, Zorub DS. Anterior surgery for cervical disc disease. Part 2: Treatment of cervical spondylotic myelopathy in 32 cases. J Neurosurg 1980;33:12–19.

    Google Scholar 

  45. McAfee PC, Bohlman HH, Yuan HA. Anterior decompression of traumatic thoracolumbar fractures with incomplete neurologic deficit using a retroperitoneal approach. J Bone Joint Surg 1985;67A:89–104.

    Google Scholar 

  46. Robertson JR, Whitesides TE, Jr. Surgical reconstruction of late post-traumatic thoracolumbar kyphosis. Spine 1985;10:307–312.

    Article  Google Scholar 

  47. Rothman R, Klemek JS and Toton JJ. The effect of iron deficiency anemia on fracture healing. Clin Orthop 1971;77:276–283.

    PubMed  CAS  Google Scholar 

  48. Bohlman H. Cervical spine and cord: trauma. Operative techniques in orthopaedic knowledge update 2: home study syllabus. Park Ridge, Illinois: American Academy of Orthopaedic Surgeons, 1987:275–276.

    Google Scholar 

  49. Southwick WO, Robinson RA. Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J Bone Joint Surg 1957;39A:631–643.

    Google Scholar 

  50. Johnson RM, Owen JR, Panjabi MM, Bucholz RW, Southwick WO. Immediate strength of certain cervical fusion techniques. Orthop Trans 1980;4:42.

    Google Scholar 

  51. Scoville WB. Discussion. J Neurosurg 1958;15:614.

    Google Scholar 

  52. Bohlman HH and Eismont FJ. Surgical techniques of anterior decompression and fusion for spinal cord injuries. Clin Orthop 1981;54:57–67.

    Google Scholar 

  53. Lipson SJ. Cervical myelopathy and posterior atlan to-axial subluxation in patients with rheumatoid arthritis. J Bone Joint Surg 1983;67A:575–583.

    Google Scholar 

  54. Lipson SJ. Rheumatoid arthritis of the cervical spine. Clin Orthop 1984;182:143–149.

    PubMed  Google Scholar 

  55. Zigler J, Rockowitz N, Capen D, Nelson R, Waters R. Posterior cervical fusion with local anesthesia. The awake patient as the ultimate spinal cord monitor. Spine 1987;12:206–208.

    Article  PubMed  CAS  Google Scholar 

  56. Callahan RA, Johnson RM, Margolis RN, Keggi KJ, Albright JA, Southwick WO. Cervical facet fusion for control of instability following laminectomy. J Bone Joint Surg 1977;59A:991–1002.

    Google Scholar 

  57. Bohler J, Ganderhak T. Anterior plate stabilization for fracture-dislocation of lower cervical spine. J Trauma 1980;20:3.

    Article  Google Scholar 

  58. Olivera JC. Anterior plate fixation of the lower cervical spine. Spine 1987;12:324–329.

    Article  Google Scholar 

  59. Carroll CC, McAfee PC. Anterior cervical plating: An initial experience. Orthop Trans 1987;11(1):8–9.

    Google Scholar 

  60. Whitehill R, Stowers SF, Fechner RE, Ruch WW, Drucker S, Gibson LR, McKernan DJ, Widmeyer JH. Posterior cervical fusions using cerclage wires, methylmethacrylate cement and autogenous bone graft: an experimental study of a canine model. Spine 1987;1:12–22.

    Article  Google Scholar 

  61. McAfee PC, Bohlman HH, Ducker T, Eismont FJ. Failure of stabilization of the spine with methylmethacrylate. A retrospective analysis of twenty-four cases. J Bone Joint Surg 1986;68A:1145–1157.

    Google Scholar 

  62. Stabler CL, Eismont FJ, Brown MD, Green BA, Malinin TL Failure of posterior cervical fusion using cadaveric bone graft in children. J Bone Joint Surg 1985;67A:370–375.

    Google Scholar 

  63. Harris IE, Weinstein SL. Long-term follow-up of patients with grade III and IV spondylolisthesis. J Bone Joint Surg 1987;69A:960–969.

    Google Scholar 

  64. Yang SW, Langrana NA, Lee CK. Biomechanics of lumbosacral spinal fusion in combined comparison-torsion loads. Spine 1986;11:937–941.

    Article  PubMed  CAS  Google Scholar 

  65. Denis F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop 1984;189:65–76.

    PubMed  Google Scholar 

  66. Zindrick MR, Wiltse LL, Widell EH, Thomas JC, Holland WR, Field BT, Spencer CW. A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine. Clin Orthop 1986;203:99–112.

    PubMed  Google Scholar 

  67. Brodsky AE. Post-laminectomy and post-fusion stenosis of the lumbar spine. Clin Orthop 1976;115:130–139.

    PubMed  Google Scholar 

  68. Steffee AD, Biscup RS, Sitkowski DJ. Segmental spine plates with pedicle screw fixation: a new interval fixation device for disorders of the lumbar and thoracolumbar spine. Clin Orthop 1986;203:45–54.

    PubMed  Google Scholar 

  69. Simeone FA. Personal communication, 1987.

    Google Scholar 

  70. Robinson RA, Southwick WO. Surgical approaches to the cervical spine. In: American Academy of Orthopaedic Surgeons: Instructional Course Lecture, Vol. XVII. St. Louis: Mosby, 1960.

    Google Scholar 

  71. Lueders H, Gurd A, Hahn J, Andrish J, Weiker G and Klem G. A new technique for intraoperative monitoring of spinal cord function: multichannel recording of spinal cord and subcortical evoked potentials. Spine 1982;7:110–115.

    Article  PubMed  CAS  Google Scholar 

  72. Griswold PW, Albright JA, Schifiman E, Johnson RM, Southwick WO. Atlantoaxial fusion for instability. J Bone Joint Surg 1978;60A:285–292.

    Google Scholar 

  73. Gallie WE. Fractures and dislocations of the cervical spine. Am J Surg 1939;46:495.

    Article  Google Scholar 

  74. Perry J. Surgical approaches to the spine. In: Pierce DH, Nickel VH, eds. Total Care of Spinal Cord Injuries. Boston: Little Brown, 1977.

    Google Scholar 

  75. Rogers WA. Treatment of fracture-dislocation of the cervical spine. J Bone Joint Surg 1942;24A:254–258.

    Google Scholar 

  76. Rogers WA. Fractures and dislocations of the cervical spine and end-result study. J Bone Joint Surg 1957;39A:2.

    Google Scholar 

  77. Mikawa Y, Shikata J, Yammuro T. Spinal deformity and instability after multilevel cervical laminectomy. Spine 1987;1:6–11.

    Article  Google Scholar 

  78. Capener N. The evolution of lateral rachotomy. J Bone Joint Surg 1954;36B(2):173–179.

    Google Scholar 

  79. Michele AA, Krueger FJ. Surgical approach to the vertebral body. J Bone Joint Surg 1949;31A:873–878.

    PubMed  CAS  Google Scholar 

  80. McAfee PC. What’s new in spinal instrumentation. American Academy of Orthopaedic Surgeons, San Francisco, California, 1987.

    Google Scholar 

  81. Langenskold A and Kiviluoto O, et al. Prevention of epidural scar formation after operation on the lumbar spine by means of a free fat transplant. Clin Orthop 1976;115:92–95.

    Google Scholar 

  82. Dick W. The “Fixateur Interne” as a versatile implant for spine surgery. Spine 1987;12:882–900.

    Article  PubMed  CAS  Google Scholar 

  83. Krag MH, Beynnon BD, Pope MH, Frymoyer JW, Hough LD, Weaver DL. An internal fixator for posterior application to short segments of the thoracic, lumbar or lumbosacral spine: design and testing. Clin Orthop 1986;203:75–98.

    PubMed  Google Scholar 

  84. Roy-Camille R, Saillant G, Mazel C. Interval fixation of the lumbar spine with pedicle screw plating. Clin Orthop 1986;203:7–17.

    PubMed  Google Scholar 

  85. Brown CW, Orme TJ, Richardson HD. The rate of pseudarthrosis (surgical nonunion) in patients who are nonsmokers: a comparison study. Spine 1986;11:942–943.

    Article  PubMed  CAS  Google Scholar 

  86. DePalma A, Rothman R. The nature of pseudarthrosis. Clin Orthop 1968;59:113–118.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. A. Alexander M. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard H. Rothman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard A. Balderston
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Jefferson Medical College of Thomas Jefferson University, 19107, Philadelphia, PA, USA

    Jerome M. Cotler M.D. (Professor and Vice Chairman) (Professor and Vice Chairman)

  2. Division of Orthopaedic Surgery, The University of Texas Medical School at Houston, Houston, TX, 77030, USA

    Howard B. Cotler M.D. (Assistant Professor of Surgery) (Assistant Professor of Surgery)

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag New York Inc.

About this chapter

Cite this chapter

Jones, A.A.M., Rothman, R.H., Balderston, R.A. (1990). Fusion Techniques for Degenerative Disease. In: Cotler, J.M., Cotler, H.B. (eds) Spinal Fusion. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3272-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-3272-8_9

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7944-0

  • Online ISBN: 978-1-4612-3272-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation