Abstract
Surgery for back pain remains highly controversial in view of the significant complication rate and the low likelihood of a successful clinical outcome.
Over the last few years, titanium and carbon fibre interbody implants have been used to stabilise spinal motion segments following sub-total removal of disc tissue. These implants offer the theoretical advantage of immediate stabilisation, avoidance of late collapse and prevention of loss of correction of pre-operative deformity in combination with other types of segmental instrumentation such as pedicle screws.
Recent long term studies have suggested the possibility of late loosening, implant migration and recurrence of segmental deformity.
A recent prospective long term study of titanium cylindrical implants for lumbar degenerative disc disease has indicated that in the presence of multi-level disease, pre-existing olisthesis and levels proximal to the lumbosacral segment, the use of supplementary pedicle screw fixation is required.
It appears, however, that despite improved radiological results, the use of interbody cages may not lead to superior functional outcomes when the surgery is carried out for non-specific low back pain.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
