Outcome of the Graf ligamentoplasty procedure compared with anterior lumbar interbody fusion with the Hartshill horseshoe cage
The objective of our study was to assess the efficacy of Graf ligamentoplasty in comparison with rigid fixation and fusion with the Hartshill horseshoe cage for similar severity of disc degeneration. Although studies have been done on the Graf ligamentoplasty procedure and the Hartshill horseshoe ca...
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Published in | European spine journal Vol. 12; no. 4; pp. 361 - 368 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
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Springer Nature B.V
01.08.2003
Springer-Verlag |
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Abstract | The objective of our study was to assess the efficacy of Graf ligamentoplasty in comparison with rigid fixation and fusion with the Hartshill horseshoe cage for similar severity of disc degeneration. Although studies have been done on the Graf ligamentoplasty procedure and the Hartshill horseshoe cage, their efficacy has never been compared in any study. This study was done to decide whether retaining mobility and stabilizing the spine is best or stiffening the lumbar segment by fusion is preferable. Between 1995 and 1997, a prospective randomized study was performed comparing Graf ligament stabilization and anterior lumbar interbody fusion. Twenty-eight patients had single-level Graf ligaments inserted and 27 patients had single-level anterior lumbar interbody fusion (ALIF) with a Hartshill horseshoe cage and tricortical iliac crest autograft. The two groups were similar in age, sex, symptoms, severity of the disc degeneration, and duration of follow-up. The chi-square test and t-test were used to evaluate the outcome. At a minimum follow-up of 2.1 years, we found that 93% of patients who had undergone Graf ligamentoplasty had a satisfactory outcome (rated "excellent" or "better") compared to 77.8% of patients who had been treated with ALIF with Hartshill horseshoe cage stabilization and fusion, when measured on the Oswestry Disability Index ( P<0.05). Retaining mobility in the lumbar segments gives better results after stabilisation with Graf ligaments than rigid fixation and fusion with the Hartshill horseshoe cage in the short term. We will be watching this cohort of patients over the next few years. |
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AbstractList | The objective of our study was to assess the efficacy of Graf ligamentoplasty in comparison with rigid fixation and fusion with the Hartshill horseshoe cage for similar severity of disc degeneration. Although studies have been done on the Graf ligamentoplasty procedure and the Hartshill horseshoe cage, their efficacy has never been compared in any study. This study was done to decide whether retaining mobility and stabilizing the spine is best or stiffening the lumbar segment by fusion is preferable. Between 1995 and 1997, a prospective randomized study was performed comparing Graf ligament stabilization and anterior lumbar interbody fusion. Twenty-eight patients had single-level Graf ligaments inserted and 27 patients had single-level anterior lumbar interbody fusion (ALIF) with a Hartshill horseshoe cage and tricortical iliac crest autograft. The two groups were similar in age, sex, symptoms, severity of the disc degeneration, and duration of follow-up. The chi-square test and t-test were used to evaluate the outcome. At a minimum follow-up of 2.1 years, we found that 93% of patients who had undergone Graf ligamentoplasty had a satisfactory outcome (rated "excellent" or "better") compared to 77.8% of patients who had been treated with ALIF with Hartshill horseshoe cage stabilization and fusion, when measured on the Oswestry Disability Index ( P<0.05). Retaining mobility in the lumbar segments gives better results after stabilisation with Graf ligaments than rigid fixation and fusion with the Hartshill horseshoe cage in the short term. We will be watching this cohort of patients over the next few years. The objective of our study was to assess the efficacy of Graf ligamentoplasty in comparison with rigid fixation and fusion with the Hartshill horseshoe cage for similar severity of disc degeneration. Although studies have been done on the Graf ligamentoplasty procedure and the Hartshill horseshoe cage, their efficacy has never been compared in any study. This study was done to decide whether retaining mobility and stabilizing the spine is best or stiffening the lumbar segment by fusion is preferable. Between 1995 and 1997, a prospective randomized study was performed comparing Graf ligament stabilization and anterior lumbar interbody fusion. Twenty-eight patients had single-level Graf ligaments inserted and 27 patients had single-level anterior lumbar interbody fusion (ALIF) with a Hartshill horseshoe cage and tricortical iliac crest autograft. The two groups were similar in age, sex, symptoms, severity of the disc degeneration, and duration of follow-up. The chi-square test and t-test were used to evaluate the outcome. At a minimum follow-up of 2.1 years, we found that 93% of patients who had undergone Graf ligamentoplasty had a satisfactory outcome (rated "excellent" or "better") compared to 77.8% of patients who had been treated with ALIF with Hartshill horseshoe cage stabilization and fusion, when measured on the Oswestry Disability Index ( P<0.05). Retaining mobility in the lumbar segments gives better results after stabilisation with Graf ligaments than rigid fixation and fusion with the Hartshill horseshoe cage in the short term. We will be watching this cohort of patients over the next few years. The objective of our study was to assess the efficacy of Graf ligamentoplasty in comparison with rigid fixation and fusion with the Hartshill horseshoe cage for similar severity of disc degeneration. Although studies have been done on the Graf ligamentoplasty procedure and the Hartshill horseshoe cage, their efficacy has never been compared in any study. This study was done to decide whether retaining mobility and stabilizing the spine is best or stiffening the lumbar segment by fusion is preferable. Between 1995 and 1997, a prospective randomized study was performed comparing Graf ligament stabilization and anterior lumbar interbody fusion. Twenty-eight patients had single-level Graf ligaments inserted and 27 patients had single-level anterior lumbar interbody fusion (ALIF) with a Hartshill horseshoe cage and tricortical iliac crest autograft. The two groups were similar in age, sex, symptoms, severity of the disc degeneration, and duration of follow-up. The chi-square test and t -test were used to evaluate the outcome. At a minimum follow-up of 2.1 years, we found that 93% of patients who had undergone Graf ligamentoplasty had a satisfactory outcome (rated "excellent" or "better") compared to 77.8% of patients who had been treated with ALIF with Hartshill horseshoe cage stabilization and fusion, when measured on the Oswestry Disability Index ( P <0.05). Retaining mobility in the lumbar segments gives better results after stabilisation with Graf ligaments than rigid fixation and fusion with the Hartshill horseshoe cage in the short term. We will be watching this cohort of patients over the next few years. |
Author | Boeree, Nicholas R Madan, Sanjeev |
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Cites_doi | 10.1001/jama.268.7.907 10.1016/0022-3999(83)90040-5 10.1097/00000658-194803000-00013 10.1097/00007632-198310000-00018 10.1007/s007010050135 10.2106/00004623-197254040-00006 10.1097/00003086-198403000-00005 10.1097/00007632-199809150-00018 10.1097/00007632-197903000-00003 10.1097/00007632-199710150-00021 10.1037/t04205-000 10.1302/0301-620X.47B2.211 10.2106/00004623-197961080-00002 10.1097/00007632-199805150-00020 10.1097/00003086-196400350-00006 10.1097/00003086-199603000-00018 10.3109/17453677809005764 10.1097/00007632-198805000-00023 10.1097/00007632-199207000-00017 10.1001/archpsyc.1965.01720310065008 10.1097/00007632-200001150-00026 10.1097/00007632-198909000-00012 10.1007/BF00298241 |
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SubjectTerms | Adult Autografts Back Pain - etiology Bone Screws Degeneration Degenerative disc disease Disability Evaluation Female Humans Iliac crest Intervertebral Disc Displacement - surgery Intervertebral discs Ligaments Ligaments, Articular - surgery Lumbar Vertebrae - surgery Male Mobility Original Pain Measurement Patient Satisfaction Prospective Studies Spinal Fusion - methods Spine (lumbar) Surveys and Questionnaires Treatment Outcome |
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Title | Outcome of the Graf ligamentoplasty procedure compared with anterior lumbar interbody fusion with the Hartshill horseshoe cage |
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