Anterior Lumbar Interbody Fusion Utilizing The AO Titanium Interbody Spacer (TIS)

John S. Thalgott, MD
James Giuffre, BA
Kay Fritts, CRNFA (Las Vegas, NV)

Introduction:

The AO Titanium Interbody Spacer (TIS) is a custom device consisting of a titanium ring and a center filled with processed sea coral (Pro Osteon 500 with a similar microstructure to cancellous bone).

Materials & Methods:

Eighty–eight (88) patients underwent successful anterior lumbar interbody fusion. Each patient was implanted with one TIS per level and all but IO had one AO Bone Graft Buttress Plate per level. Forty–two (42) were done through an open anterior retroperitoneal approach, 46 through a retroperitoneal gasiess endoscopic approach (B.E.R.G.). All patients also were implanted with posterior fixation and posterolateral fusion.

Results:

Average follow–up in this series was 36 months with a range of 24 to 51 months. Perioperatively, 17 endoscopic cases were converted to open procedures, and counted as an open approach for this study. Five (5) patients had their posterior hardware completely removed. Of those, 3 were fused. There was one device migration in a patient without a buttress plate. Radiographic evaluation demonstrated a 92% fusion rate. Average pain decrease was 63% with 69% of patients reporting good or excellent pain relief. Fifty per cent (50%) of patients working prior to surgery returned to work. Patients done through the endoscopic approach had better pain relief and better return to work rates than those done through the open approach.

Conclusion:

Based on these results, we believe the AO Titanium lnterbody Spacer is safe and effective for interbody fusion of the lumbar spine when used in conjunction with rigid posterior internal fixation and fusion.