The long follow-up time in clinical trials and subjective endpoints of pain and quality of life continue to create market acceptance issues for new spinal surgery techniques. Cages are the latest example, as emerging long-term follow-up data bring into question their ability to enhance spinal fusion. Many believe artificial discs will eventually move orthopedics along the continuum from repair and restoration to replacement, but creating a physiologically active device capable of pumping water and waste, and determining which patients will benefit from it, is a formidable long-term challenge. In the meantime, minimally invasive spinal decompression procedures including vertebroplasty and kyphoplasty are gaining in popularity, as are, to some extent, radiofrequency techniques such as IDET. But here too, until multi-year follow-data from prospective trials are available, their use will also remain controversial.
by Mark L. Ratner
The X-ray showed a patient several weeks after undergoing spinal surgery. Threaded interbody fusion cages—small metallic cylinders with perforated sides that are placed in pairs between destabilized vertebrae to decompress...
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