Brief review
*Title: The
memory metal minimal access cage: a new concept in lumbar interbody fusion-a
prospective, noncomparative study to evaluate the safety and performance
*Authors: D. Kok, R. D. Donk, F. H.Wapstra, and A. G.
Veldhuizen
*Bibliography: Adv Orthop. 2012;2012:898606.
Study Design
A single-centre, prospective, non-comparative study
Objective
To evaluate the performance and safety
of the Memory Metal Minimal Access Cage (MAC) in Lumbar Interbody Fusion.
Summary of
Background Data
Interbody fusion cages in general are designed to
withstand high axial loads and in the meantime to allow ingrowth of new bone
for bony fusion.
In many cages the contact area with the endplate is rather
large leaving a relatively small contact area for the bone graft with the
adjacent host bone.
MAC is constructed from the memory metal Nitinol and
builds on the concept of sufficient axial support in combination with a large
contact area of the graft facilitating bony ingrowth and ease in minimal access
implantation due to its high deformability.
Methods
▶Subjects: 25 patients with back and radicular
leg pain from a single level degenerative lumbar disc underwent an interbody
fusion using MAC and pedicle screws.
▶Clinical
evaluation: Oswestry Disability Index (ODI), Short Form 36 questionnaire
(SF-36) and pain visual analogue scale (VAS) scores
-The interbody fusion status was assessed using
conventional radiographs and CT scan.
-Safety of the device was studied by registration of
intra- and post-operative adverse effects.
Results
▶Clinical
performance: improved significantly (P < .0018)
-CT scan confirmed solid fusion in all 25 patients at two
year follow-up.
-In 2 patients migration of the cage occurred, which was
resolved uneventfully by placing a larger size at the subsequent revision.
Conclusions
We conclude that the Memory Metal Minimal Access Cage (MAC)
resulted in 100% solid fusions in 2 years and proved to be safe, although two
patients required revision surgery in order to achieve solid fusion.
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