Comparison of SpineJet™ XL and Conventional Instrumentation for Disk Space Preparation in Unilateral Transforaminal Lumbar Interbody Fusion

Department of Neurosurgery, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea.
Journal of Korean Neurosurgical Society (Impact Factor: 0.64). 05/2010; 47(5):370-6. DOI: 10.3340/jkns.2010.47.5.370
Source: PubMed


Although unilateral transforaminal lumbar interbody fusion (TLIF) is widely used because of its benefits, it does have some technical limitations. Removal of disk material and endplate cartilage is difficult, but essential, for proper fusion in unilateral surgery, leading to debate regarding the surgery's limitations in removing the disk material on the contralateral side. Therefore, authors have conducted a randomized, comparative cadaver study in order to evaluate the efficiency of the surgery when using conventional instruments in the preparation of the disk space and when using the recently developed high-pressure water jet system, SpineJet™ XL.

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    ABSTRACT: Randomized, technical study in 7 samples from 2 cadavers. To compare transforaminal lumbar discectomies performed by 2 experienced surgeons using either the conventional technique or the new powered Spine Shaver (SS) instrument. The SS was designed to offer an easier and safer procedure than the conventional technique. The 7 samples were randomly operated by the 2 surgeons. The conventional or SS techniques were randomly selected. The endplate cartilage was removed and photographed. The amounts of cartilage removed were measured through computer-based analysis software. The number of instrument insertions was nearly 6-fold more frequent with the conventional technique (56.4) than with the SS (12.3). The volume of disk removed was approximately 50% higher with the SS (6.525 cm) than with the conventional technique (4.333 cm). The areas of cartilages removed were higher using the SS (2.297 cm) than with the conventional technique (2.1 cm). The endplate damages were 0.1 and 0.3 cm for the SS and conventional techniques, respectively. The SS allows a better quality of preparation, and minimizes the risks of damaging surrounding structures related to multiple movements of manual tools.
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