The success of posterior lumbar interbody fusion (PLIF) has been limited by mechanical and biologic deficiencies of the donor bone. The authors have designed a carbon fiber-reinforced polymer implant that separates the mechanical and biologic functions of PLIF. The cagelike implant provides an actual device designed to meet the mechanical requirements of PLIF and replaces the donor bone with autologous bone, the best possible bone for healing. The authors report 2-year follow-up results for their first 26 consecutive patients, 18 of whom were postsurgical failed backs with a total of 37 previous surgeries. At 2 years, 28 of 28 PLIF cage fusion levels and 6 of 11 (54.5%) allograft levels exhibited radiographic fusion, a statistically significant difference at P = 0.0002. Clinical results were excellent in 11/26, good in 10/26, fair in 3/26, and poor in 2/26. Fair and poor results were attributable to objective identifiable problems unrelated to the carbon cage. The carbon implant achieved successful fusion in 6/6 (100%) of followed patients treated for a failed ETO allograft interbody fusion. A prospective controlled multi-centered study is being initiated.
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