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Introduction:
The intervertebral fusion cage is a large, hollow cylinder made of
some type of metal, usually titanium. It is designed as a "cage" so
that bone graft can be placed inside the hollow cylinder to allow a
spinal fusion to occur between two vertebrae. The holes that are
throughout the cage allow bone to form around and through the cage
connecting the two vertebrae with solid bone.
Many of the newer types of intervertebral fusion cages are also
designed to allow performing the spinal fusion either using an open
incision or a laparoscopic procedure. An open incision is the
traditional way of performing surgery, where larger incisions are
made to allow the surgeon to see where he is operating and perform
the procedure. A laparoscopic procedure is performed using much
smaller incisions and using a special TV camera inserted into the
abdomen to allow the surgeon to see where he is operating and
perform the procedure. The laparoscopic approach can be much less
damaging to normal tissue and can speed recovery. On the other
hand, the laparoscopic approach is sometimes very difficult to
perform and may not be possible in all cases.
The intervertebral fusion cage is designed to do several things.
First, the cage is used to spread the two vertebrae apart, which
allows several things to occur. The openings in the back of the
spine where the nerve roots leave the spine become larger - making
more room for the nerves. This decreases the pinching and
irritation on the nerves. The strong ligaments that surround the
disc tighten as the cage forces the vertebrae back apart. This
decreases the segmental instability between the two vertebrae and
decreases the mechanical pain in the spine. Second, the
intervertebral fusion cage sits between the two vertebrae to
replace the disc and hold the two vertebrae in the correct position
until a fusion occurs between the vertebrae.