555 - MIS vs. Percutaneous Lumbar Interbody Fusion with OptiMesh...

#555 MIS vs. Percutaneous Lumbar Interbody Fusion with OptiMesh

MIS Techniques and Outcomes

Poster Presented by: S. Lavoie

Author(s):

S. Lavoie (1)

(1) Florida Orthopaedic Associates, Deland, FL, United States

Abstract

An IRB approved, observational, retrospective chart review was conducted at a single center to evaluate patients with symptomatic single-level lumbar conditions treated with OptiMesh Graft Containment System* (Spineology Inc., St. Paul, MN) as the interbody fusion device with bilateral pedicle screw fixation. All patients having surgery between 10/2007 through 12/2012, and that had a minimum 6-mo post-op visit were invited to participate in study. After chart review, 98 patients met protocol inclusion criteria. A comparison of outcomes was made between MIS (TLIF or PLIF) and percutaneous techniques for implant of OptiMesh.

OptiMesh was filled with AFT bone graft* from MTF (Musculoskeletal Transplant Foundation, Edison, NJ). No BMP, graft extenders, or other biologics were used.

Results: There were 57 females (58%) and 41 males (42%) with an average age of 59 years (range: 37 to 84) and an average BMI of 29 (range: 17.3 to 42.9). Average follow up was 18 months (range: 6 to 63). Primary diagnoses; spondylolisthesis with stenosis = 51, DDD with stenosis = 39, junctional DDD = 5, and pseudoarthrosis = 3. Levels treated; L1-2 = 1, L2-3 = 6, L3-4 = 8, L4-5 = 63, and L5-S1 = 20.

Forty-six procedures involved percutaneous placement (Group 1) of the OptiMesh interbody device and 52 procedures involved an open approach, PLIF or TLIF (Group 2). For Group 1, the average EBL was 107cc versus 180cc for Group 2. Hospital LOS for Group 1 was 1.6 days versus 2.1 days for Group 2. Average OR time for Group 1 was 143 min for percutaneous vs. 168 min for Group 2.

Clinical results at latest follow-up and complications will be presented.

Fifty patients (51%) had an x-ray at least 12 months post-op. (44 between 9-15mo, and 6 with >15mo). Films read by independent radiologist for presence of bridging bone into the graft pack. Of the 44 patients with x-ray between 9-15mo p-op, 39 (89%) deemed fused, 1 deemed not fused (early TLIF) and 4 indeterminate (poor x-rays).

Conclusions: In the author's practice, OptiMesh is more recently implanted primarily through the percutaneous technique, which, combined with percutaneous pedicle screw instrumentation, is yielding good fusion and clinical outcomes.

*Not FDA cleared for this indication