Anterior Lumbar Interbody Fusion

Anterior Lumbar Interbody Fusion

Instruments

Easy to use instruments are available, comprising the following:

  • “T” handle to hold the spacer trial. (Code: OSASTH)
  • “T” handle for cage insertion (Code: OSACH)
  • Spacer trials for each of the sizes in the table above (Codes as per table)

Cage Insertion Technique

  • Insert the trial into the space where the disc has been removed.
  • Release the retractors.
  • Ensure that the trial fits correctly in the disc space.
  • If the fit is correct, prepare the cage size that corresponds to the trial size and prepare it with bone (allograft, or autograft bone). See appendix A.
  • Insert the cage into the disc space, ensuring that it is positioned centrally with reference to the lateral aspects.
  • The depth of the cage is determined by the stopper on the inserter. (This depth is ideally about 1mm posterior to the anterior cortex.)

Appendix A

  • The cage can be filled with either autograft bone (e.g. from the iliac crest), allograft bone (e.g. lyophilized bone, freeze dried bone), or else bone substitute (e.g. tri-calcium phosphate, bi-calcium phosphate, etc).
  • The choice of void filler used is the surgeon’s preference after the necessary benefits have been carefully considered.
  • Void filler should ideally protrude fractionally from both the cephalad and the caudal planes of the cage to allow for the initial resorbtion that occurs