Questions & Answers features staff members of
Rockhill Orthopaedics, the Kansas City Spine Center, and the Health and
Rehabilitation Pavilion. This issue, we feature Robert Takacs, MD,
orthopedic surgeon, and director of the Kansas City Spine Center.
What is the significance of
the new threaded fusion cage device?
It offers an alternative way of treating problems of the lower spine
caused by degenerative disc disease (DDD). We can successfully help many
patients with back pain who were unresponsive to normal conservative treatment.
Studies show 90% of patients will fuse, and over 80% will have clinical
improvement.
When is a spinal fusion
warranted for a patient?
We all have discs in our backs that cushion the vertebrae in the lumbar spine.
Through injury or normal wear and tear these discs can wear down or dry out,
causing the disc space to collapse. The result can be back and leg pain. The
purpose of a fusion is to stabilize and then fuse that space, which alleviates
the pain.
What does the threaded
fusion cage device look like?
It looks like a hollow cylinder or screw with holes in it. It's
made of titanium, which is compatible with the human body and has been used for
some time with joint replacements. The design is revolutionary. The fusion cage
provides support, and at the same time it allows bone graft to grow through it.
How is its use an
improvement on the old technique?
In the past, after we surgically remove the worn disc, we used the
patient's bone to fuse the vertebrae. In some patients this could eventually
collapse. We haven't had a good safe method of maintaining disc height and also
maintaining solid fusion prior to this. The fusion cage stabilizes the disc
space. It is filled with bone taken from the patient's hip that eventually grows
through the holes and fuses the vertebrae together.
Is the device the answer
for everyone with lower back pain?
It's not for everyone and my only reservation about it is the
possibility that it will be over applied. We need to stick to the strict
criteria set forth by the FDA. But so far I'm very pleased with the results I've
had with patients. This is an exciting new tool in the treatment of back pain.
("On Track", Winter 1998)
