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Interbody Fusion Devices
Lubdha M. Shah, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Interbody fusion device (IFD), implant, cage, spacer
          • Definitions

            • Fusion across disc space
              • Restore and maintain disc space height and normal sagittal contours
              • Increase stability of operated segment(s)
            • Cervical
              • Anterior cervical discectomy with fusion (ACDF) ± plating is standard treatment of cervical degenerative disc disease (DDD)
            • Thoracic
              • Disc release and interbody cage placement
            • Lumbar
              • Lumbar fusion for back pain ± leg pain associated with DDD is the gold standard

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Chau AM et al: Current status of bone graft options for anterior interbody fusion of the cervical and lumbar spine. Neurosurg Rev. 37(1):23-37, 2014
                                        2. Gruskay JA et al: Methods of evaluating lumbar and cervical fusion. Spine J. 14(3):531-9, 2014
                                        3. Kim KH et al: Adjacent segment disease after interbody fusion and pedicle screw fixations for isolated L4-L5 spondylolisthesis: a minimum five-year follow-up. Spine (Phila Pa 1976). Epub ahead of print, 2010
                                        4. Cho KS et al: Risk factors and surgical treatment for symptomatic adjacent segment degeneration after lumbar spine fusion. J Korean Neurosurg Soc. 46(5):425-30, 2009
                                        5. Kaiser MG et al: Radiographic assessment of cervical subaxial fusion. J Neurosurg Spine. 11(2):221-7, 2009
                                        6. Lee CS et al: Risk factors for adjacent segment disease after lumbar fusion. Eur Spine J. 18(11):1637-43, 2009
                                        7. Ryken TC et al: Techniques for cervical interbody grafting. J Neurosurg Spine. 11(2):203-20, 2009
                                        8. Lebwohl NH et al: Radiographic evaluation of the postoperative interbody fusion patient: is CT the study of choice? AJNR Am J Neuroradiol. 26(8):1885-6; discussion 1886-7, 2005
                                        9. Williams AL et al: CT evaluation of lumbar interbody fusion: current concepts. AJNR Am J Neuroradiol. 26(8):2057-66, 2005
                                        10. Cook SD et al: Comparison of methods for determining the presence and extent of anterior lumbar interbody fusion. Spine (Phila Pa 1976). 29(10):1118-23, 2004
                                        11. Errico TJ: Why a mechanical disc? Spine J. 4(6 Suppl):151S-157S, 2004
                                        12. Goffin J et al: Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech. 17(2):79-85, 2004
                                        13. Lanman TH et al: Early findings in a pilot study of anterior cervical interbody fusion in which recombinant human bone morphogenetic protein-2 was used with poly(L-lactide-co-D,L-lactide) bioabsorbable implants. Neurosurg Focus. 16(3):E6, 2004
                                        14. Umehara S et al: The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine (Phila Pa 1976). 25(13):1617-24, 2000
                                        15. Hilibrand AS et al: Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 81(4):519-28, 1999
                                        16. Phillips FM et al: Anterior cervical pseudarthrosis. Natural history and treatment. Spine (Phila Pa 1976). 22(14):1585-9, 1997
                                        17. West JL 3rd et al: Results of spinal arthrodesis with pedicle screw-plate fixation. J Bone Joint Surg Am. 73(8):1179-84, 1991
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Interbody fusion device (IFD), implant, cage, spacer
                                                • Definitions

                                                  • Fusion across disc space
                                                    • Restore and maintain disc space height and normal sagittal contours
                                                    • Increase stability of operated segment(s)
                                                  • Cervical
                                                    • Anterior cervical discectomy with fusion (ACDF) ± plating is standard treatment of cervical degenerative disc disease (DDD)
                                                  • Thoracic
                                                    • Disc release and interbody cage placement
                                                  • Lumbar
                                                    • Lumbar fusion for back pain ± leg pain associated with DDD is the gold standard

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          • Nuclear Medicine Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Chau AM et al: Current status of bone graft options for anterior interbody fusion of the cervical and lumbar spine. Neurosurg Rev. 37(1):23-37, 2014
                                                                              2. Gruskay JA et al: Methods of evaluating lumbar and cervical fusion. Spine J. 14(3):531-9, 2014
                                                                              3. Kim KH et al: Adjacent segment disease after interbody fusion and pedicle screw fixations for isolated L4-L5 spondylolisthesis: a minimum five-year follow-up. Spine (Phila Pa 1976). Epub ahead of print, 2010
                                                                              4. Cho KS et al: Risk factors and surgical treatment for symptomatic adjacent segment degeneration after lumbar spine fusion. J Korean Neurosurg Soc. 46(5):425-30, 2009
                                                                              5. Kaiser MG et al: Radiographic assessment of cervical subaxial fusion. J Neurosurg Spine. 11(2):221-7, 2009
                                                                              6. Lee CS et al: Risk factors for adjacent segment disease after lumbar fusion. Eur Spine J. 18(11):1637-43, 2009
                                                                              7. Ryken TC et al: Techniques for cervical interbody grafting. J Neurosurg Spine. 11(2):203-20, 2009
                                                                              8. Lebwohl NH et al: Radiographic evaluation of the postoperative interbody fusion patient: is CT the study of choice? AJNR Am J Neuroradiol. 26(8):1885-6; discussion 1886-7, 2005
                                                                              9. Williams AL et al: CT evaluation of lumbar interbody fusion: current concepts. AJNR Am J Neuroradiol. 26(8):2057-66, 2005
                                                                              10. Cook SD et al: Comparison of methods for determining the presence and extent of anterior lumbar interbody fusion. Spine (Phila Pa 1976). 29(10):1118-23, 2004
                                                                              11. Errico TJ: Why a mechanical disc? Spine J. 4(6 Suppl):151S-157S, 2004
                                                                              12. Goffin J et al: Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech. 17(2):79-85, 2004
                                                                              13. Lanman TH et al: Early findings in a pilot study of anterior cervical interbody fusion in which recombinant human bone morphogenetic protein-2 was used with poly(L-lactide-co-D,L-lactide) bioabsorbable implants. Neurosurg Focus. 16(3):E6, 2004
                                                                              14. Umehara S et al: The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine (Phila Pa 1976). 25(13):1617-24, 2000
                                                                              15. Hilibrand AS et al: Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 81(4):519-28, 1999
                                                                              16. Phillips FM et al: Anterior cervical pseudarthrosis. Natural history and treatment. Spine (Phila Pa 1976). 22(14):1585-9, 1997
                                                                              17. West JL 3rd et al: Results of spinal arthrodesis with pedicle screw-plate fixation. J Bone Joint Surg Am. 73(8):1179-84, 1991