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  • biofreeze
    Participant
    Post count: 99

    Thank you

    As you know, some surgeons will fix a grade one spondy with an ALIF then roll you over and put perc screws in to back you up, leaving facets and pars fracture in tact. Their argument is, less cutting and no nerve retraction.

    would this mean that the patient would receive the other 20-30% support with the perc screws as back up and 80% support with ALIf in the front ?

    I looked up bommerang cage and doesn’t look that much smaller than synfix ALIF cage, especially the larger boomerang cage.

    biofreeze
    Participant
    Post count: 99

    Hey Dr. Corenman

    Any word back on my question. Trying to get an idea of stability of alif with just Perc screws as back up.

    Thank you again

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    The anterior, then posterior approach is much more “cutting” than a simple posterior TLIF approach. The boomerang cage will be about 6-7mm in height with a TLIF vs. an 8-10mm cage with an ALIF. The cage is about 9mm wide vs. an ALIF cage which is about 35mm wide.

    Leaving the pars fracture intact means that autogenous bone graft is not used which is in my opinion a mistake.

    The stability of an ALIF with percutaneous pins will be the same as a TLIF.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    biofreeze
    Participant
    Post count: 99

    Thank you

    My confusion is :

    I will simply have perc screws as back up without posterolateral fusion as you often suggest.

    Therefore, if disc space carries 70-80% of the support through the spinal column, will I be left with 20-30% less stability because I will not have posterolateral fusion, especially if the perc screws need to be taken out at a later date.

    Please let me know your thoughts.

    Also, does the width of the cage really matter. ALIF seems to be much wider.

    Thank you !

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Percutaneous screws (the “MIS” approach) exposes the transverse processes and the ala of the sacrum. These surfaces are perfect for a fusion. Ask your surgeon if he or she will “throw some bone graft” into this area after decortication and the fusion will be reenforced.

    The ALIF allows a larger cage to be placed as the anterior longitudinal ligament has been removed to allow access to the disc space. This allows a larger cage to be placed as the space is “less confined”. The cage size has little bearing on the fusion.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    biofreeze
    Participant
    Post count: 99

    Thank you very much for your explanation !

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