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Jeffrey D. Coe

Object

The purpose of this study was to evaluate the clinical and radiographic results in 31 patients from one center who underwent instrumented transforaminal lumbar interbody fusion (TLIF) for primarily degenerative indications.

Methods

Bioabsorbable polymer spacers manufactured with a copolymer of 70:30 poly(L-lactide-co-D,L-lactide) and filled with iliac crest autograft bone were used for the TLIF procedure. In this paper the details of this procedure, intermediate (1- to 2-year) clinical and radiographic outcomes, and the basic science and rationale for the use of bioabsorbable polymers are discussed. At a mean of 18.4 months of follow up, 30 patients (96.8%) were judged to have attained solid fusions and 25 patients (81%) had good to excellent results. Three patients (9.7%) experienced complications, none of which were directly or indirectly attributable to the use of the bioabsorbable polymer implant. Only one implant in one patient (3.2%) demonstrated mechanical failure on insertion, and that patient experienced no clinical sequelae.

Conclusions

This is the first clinical series to be published in which the mean follow-up duration equals or exceeds the biological life expectancy of this material (12–18 months). Both the clinical and radiographic results of this study support the use of interbody devices manufactured from biodegradable polymers for structural interbody support in the TLIF procedure.

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Thomas G. Lowe and Jeffrey D. Coe

Object. Sixty patients underwent instrumentation-assisted posterior transforaminal lumbar interbody fusion (TLIF) with resorbable polymer cages and autograft bone for degenerative disease. This article discusses the technique of TLIF and its early outcomes.

Methods. Although the follow-up period is short and results are preliminary, no adverse events or complications were attributed to the resorbable polymer.

Conclusions. Further multicenter clinical studies are underway with a minimum 2-year follow-up period chosen as an endpoint to provide insight as to the future of biodegradable polymers as spinal interbody devices.

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Jeffrey D. Coe, Alexander R. Vaccaro, Andrew T. Dailey, Rick C. Sasso, Steven C. Ludwig, James S. Harrop, Joseph R. Dettori, Christopher I. Shaffrey, Sanford E. Emery and Michael G. Fehlings