Lumbar or Low Back Implants to Fix the Spine
Lumbar implants are orthopedic devices surgeons use to decompress and stabilize the spine (low back). Implants used in lumbar fusion surgery are provided from top orthopedic implants company in India they can be divided into two groups:
1. Those placed within the interbody space
2. Those placed onto the spine to deliver stabilization
The purpose of lumbar or low back stabilization orthopedic implants is to:
1. Help restore and maintain normal alignment of the lumbar spine
2. Keep the spine fixed or stable during the fusion process
Stabilization implants are considered temporary devices as their function stops once fusion occurs. They may be removed after solid fusion if considered essential. Although, in most cases, implants are not removed.
These are examples of stabilization implants:
Anterior Lumbar Plates
Wide plates are often placed at the L5-S1 level during an anterior (front) lumbar interbody fusion (ALIF) procedure. The plates are made with screw holes through which bone screws anchor the plates onto the vertebral body. The plate prevents the interbody space from opening when the patient bends backward. This lessens loosening of the interbody cages and helps to prevent disruption. Occasionally, anterior places are placed at the L4-L5 level.
Pedicle screws come in different lengths and diameters, and made from metal; either stainless or titanium. These specially designed screws are placed from the back through the cylinder-shaped pedicle hole into the vertebral body. Surgeons like pedicle screws because they deliver a stable anchor to the spine. Screws are usually fit into both pedicles of a vertebra. Then, the pedicle screws are attached to plates or rods, which extend to adjacent vertebrae to provide a stable fixation so fusion occurs.
Lumbar Plates are available in various lengths and with many holes for pedicle screw attachment. Nuts lock each plate to the screws. As lumbar plates are stiff, they provide a stable fixation to the posterior or back spine. The plates are made from stainless steel or titanium. Newer plate materials are being developed.
Rods connect to pedicle screws to deliver stabilization. Rods are more adaptable than plates and provide the surgeon more choices when placing pedicle screws. Different types of connectors solidly fix the screws and rod together. Rods are mainly made from metals like stainless steel, titanium and sometimes, cobalt chrome.
Hooks attach over the tops of the lamina and are connected by rods. Now, hooks have largely been replaced by pedicle screws, although hooks are at times added to pedicle screw fixation.
Cables and Wires are wrapped around the spinous or lamina processes and tightened to limit motion. Seldom are cables and wires used to surgically treat lumbar degenerative disorders.
Crosslinks
One or two crosslinks may be used to attach two long rods or plates together. Crosslinks deliver more stability for long implant constructs. They are made from the same materials as the plates and rods to which they connect.
Role of Bone Graft
Whatever implants the surgeon selects, the final stability of the spine eventually results from fusion- and fusion is enhanced by bone graft. Autograft is the bone of patient and allograft is bone of a donor. A genetically engineered protein, recombinant human bone morphogenetic protein (rhBMP-2), stimulates the body to produce natural bone quickly.
New Lumbar Technology
New implants for the treatment of lumbar or low back degenerative disease have recently been approved by the U.S. Food and Drug Administration (FDA). These implants address the question of whether it is better to preserve movement at the disease site rather than fuse it. They can be divided into two groups:
1. Interbody motion devices (artificial discs)
2. Interspinous process decomposition devices
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