Cargando…
Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage)
INTRODUCTION: Surgical management of degenerative lumbar spine disorders is effective at improving patient pain, disability, and quality of life; however, obtaining a durable posterolateral fusion after decompression remains a challenge. Interbody fusion technologies are viable means of improving fu...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society for Spine Surgery and Related Research
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9747220/ https://www.ncbi.nlm.nih.gov/pubmed/36561152 http://dx.doi.org/10.22603/ssrr.2021-0252 |
_version_ | 1784849546816258048 |
---|---|
author | Khan, Inamullah Parker, Scott L. Bow, Hansen Sivaganesan, Ahilan Pennings, Jacquelyn S. Stephens II, Byron F. Steinle, Anthony M. Gupta, Rishabh Devin, Clinton J. |
author_facet | Khan, Inamullah Parker, Scott L. Bow, Hansen Sivaganesan, Ahilan Pennings, Jacquelyn S. Stephens II, Byron F. Steinle, Anthony M. Gupta, Rishabh Devin, Clinton J. |
author_sort | Khan, Inamullah |
collection | PubMed |
description | INTRODUCTION: Surgical management of degenerative lumbar spine disorders is effective at improving patient pain, disability, and quality of life; however, obtaining a durable posterolateral fusion after decompression remains a challenge. Interbody fusion technologies are viable means of improving fusion rates in the lumbar spine, specifically various graft materials including autograft, structural allograft, titanium, and polyether ether ketone. This study assesses the effectiveness of Tritanium posterolateral cage in the treatment of degenerative disk disease. METHODS: Nearest-neighbor 1:1 matched control transforaminal lumbar interbody fusion with PEEK vs. Tritanium posterior lumbar (PL) cage interbody fusion patients were identified using propensity scoring from patients that underwent elective surgery for degenerative disk diseases. Line graphs were generated to compare the trajectories of improvement in patient-reported outcomes (PROs) from baseline to 3 and 12 months postoperatively. The nominal data were compared via the χ(2) test, while the continuous data were compared via Student's t-test. RESULTS: The two groups had no difference regarding either the 3- or 12-month Euro-Qol-5D (EQ-5D), numeric rating scale (NRS) leg pain, and NRS back pain; however, the Tritanium interbody cage group had better Oswestry Disability Index (ODI) scores compared to the control group of the PEEK interbody cage at both 3 and 12 months (p=0.013 and 0.048). CONCLUSIONS: Our results indicate the Tritanium cage is an effective alternative to the previously used PEEK cage in terms of PROs, surgical safety, and radiological parameters of surgical success. The Tritanium cohort showed better ODI scores, higher fusion rates, lower subsidence, and lower indirect costs associated with surgical management, when compared to the propensity-matched PEEK cohort. |
format | Online Article Text |
id | pubmed-9747220 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Japanese Society for Spine Surgery and Related Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-97472202022-12-21 Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) Khan, Inamullah Parker, Scott L. Bow, Hansen Sivaganesan, Ahilan Pennings, Jacquelyn S. Stephens II, Byron F. Steinle, Anthony M. Gupta, Rishabh Devin, Clinton J. Spine Surg Relat Res Original Article INTRODUCTION: Surgical management of degenerative lumbar spine disorders is effective at improving patient pain, disability, and quality of life; however, obtaining a durable posterolateral fusion after decompression remains a challenge. Interbody fusion technologies are viable means of improving fusion rates in the lumbar spine, specifically various graft materials including autograft, structural allograft, titanium, and polyether ether ketone. This study assesses the effectiveness of Tritanium posterolateral cage in the treatment of degenerative disk disease. METHODS: Nearest-neighbor 1:1 matched control transforaminal lumbar interbody fusion with PEEK vs. Tritanium posterior lumbar (PL) cage interbody fusion patients were identified using propensity scoring from patients that underwent elective surgery for degenerative disk diseases. Line graphs were generated to compare the trajectories of improvement in patient-reported outcomes (PROs) from baseline to 3 and 12 months postoperatively. The nominal data were compared via the χ(2) test, while the continuous data were compared via Student's t-test. RESULTS: The two groups had no difference regarding either the 3- or 12-month Euro-Qol-5D (EQ-5D), numeric rating scale (NRS) leg pain, and NRS back pain; however, the Tritanium interbody cage group had better Oswestry Disability Index (ODI) scores compared to the control group of the PEEK interbody cage at both 3 and 12 months (p=0.013 and 0.048). CONCLUSIONS: Our results indicate the Tritanium cage is an effective alternative to the previously used PEEK cage in terms of PROs, surgical safety, and radiological parameters of surgical success. The Tritanium cohort showed better ODI scores, higher fusion rates, lower subsidence, and lower indirect costs associated with surgical management, when compared to the propensity-matched PEEK cohort. The Japanese Society for Spine Surgery and Related Research 2022-04-12 /pmc/articles/PMC9747220/ /pubmed/36561152 http://dx.doi.org/10.22603/ssrr.2021-0252 Text en Copyright © 2022 The Japanese Society for Spine Surgery and Related Research https://creativecommons.org/licenses/by-nc-nd/4.0/Spine Surgery and Related Research is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Khan, Inamullah Parker, Scott L. Bow, Hansen Sivaganesan, Ahilan Pennings, Jacquelyn S. Stephens II, Byron F. Steinle, Anthony M. Gupta, Rishabh Devin, Clinton J. Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) |
title | Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) |
title_full | Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) |
title_fullStr | Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) |
title_full_unstemmed | Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) |
title_short | Clinical and Cost-Effectiveness of Lumbar Interbody Fusion Using Tritanium Posterolateral Cage (vs. Propensity-Matched Cohort of PEEK Cage) |
title_sort | clinical and cost-effectiveness of lumbar interbody fusion using tritanium posterolateral cage (vs. propensity-matched cohort of peek cage) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9747220/ https://www.ncbi.nlm.nih.gov/pubmed/36561152 http://dx.doi.org/10.22603/ssrr.2021-0252 |
work_keys_str_mv | AT khaninamullah clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT parkerscottl clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT bowhansen clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT sivaganesanahilan clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT penningsjacquelyns clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT stephensiibyronf clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT steinleanthonym clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT guptarishabh clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage AT devinclintonj clinicalandcosteffectivenessoflumbarinterbodyfusionusingtritaniumposterolateralcagevspropensitymatchedcohortofpeekcage |