Our Summary

This research paper looks at the history and development of a specific type of spinal implant, known as the Hartshill Horseshoe. This implant is used in a procedure called anterior lumbar interbody fusion (ALIF), which is a common type of spinal surgery.

The researchers looked at information from online databases, focusing on how the implant was developed, and also spoke to the people who originally patented the Hartshill Horseshoe. Their search only included information from before 1995.

The concept of ALIF was first proposed in 1932 and the first surgery was performed in 1933 with a tibial peg. The first use of a bone graft as a spacer in ALIF was reported in 1936. Over time, bone grafts became a common part of the procedure. However, ALIF was not commonly performed due to varying results.

In 1971, a small study reported the use of titanium mesh blocks as implants in 6 patients. The Hartshill Horseshoe, developed in 1984, was the first synthetic standalone ALIF implant. Since then, many such implants have been designed.

The benefit of using a standalone implant like the Hartshill Horseshoe is that it provides immediate stability, can help correct deformities after being implanted, prevents the implant from moving around, and encourages the bone to grow around the implant.

FAQs

  1. What is the Hartshill Horseshoe and what procedure is it used in?
  2. When was the concept of anterior lumbar interbody fusion (ALIF) first proposed and when was the first surgery performed?
  3. What are the benefits of using a standalone implant like the Hartshill Horseshoe in ALIF?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion using implants like the Hartshill Horseshoe is to follow post-operative instructions carefully, including proper rest, physical therapy exercises, and avoiding activities that could put strain on the spine. It is important to give the fusion time to heal and for the bone to grow around the implant for long-term stability. Patients should also maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall spinal health. Regular follow-up appointments with the doctor are also crucial to monitor the healing process and address any concerns.

Suitable For

Patients who are typically recommended spinal fusion, such as ALIF using implants like the Hartshill Horseshoe, include those with conditions such as degenerative disc disease, spinal stenosis, spondylolisthesis, fractures, scoliosis, and tumors. These patients may experience symptoms such as chronic pain, weakness, numbness, or tingling in the back, legs, or arms, and may have tried non-surgical treatments without success.

Spinal fusion is often recommended when conservative treatments have not provided relief, and when there is instability or abnormal motion in the spine that is causing symptoms. The decision to undergo spinal fusion surgery is made on a case-by-case basis, taking into consideration the patient’s overall health, the extent of their spine condition, and their goals for treatment.

It is important for patients considering spinal fusion to have a thorough discussion with their healthcare provider about the risks and benefits of the procedure, as well as the expected outcomes and potential alternatives. Spinal fusion is a major surgery that requires a period of recovery and rehabilitation, so patients should be prepared for the commitment involved in the process.

Timeline

Before undergoing spinal fusion surgery, a patient typically experiences chronic back or neck pain, weakness or numbness in the extremities, difficulty walking or standing for long periods, and limitations in daily activities. They may have tried conservative treatments such as physical therapy, medications, or injections with little to no relief.

After undergoing spinal fusion surgery, a patient may experience immediate pain relief due to the stabilization of the spine. However, they may also experience post-operative pain, difficulty moving or bending, and a longer recovery period. It can take several months to a year for the bone to fully fuse and for the patient to regain full mobility and function. Physical therapy and rehabilitation are usually necessary to help the patient regain strength and flexibility in the spine.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion, specifically regarding the Hartshill Horseshoe implant, may include:

  1. What specific type of spinal fusion procedure will be performed, and why is the Hartshill Horseshoe implant being used in my case?
  2. How long has the surgeon been performing spinal fusion surgeries with the Hartshill Horseshoe implant?
  3. What are the potential risks and complications associated with using the Hartshill Horseshoe implant in spinal fusion surgery?
  4. What is the expected recovery time and rehabilitation process following spinal fusion with the Hartshill Horseshoe implant?
  5. Are there any alternative treatments or implants that could be considered for my specific spinal condition?
  6. How successful has the Hartshill Horseshoe implant been in previous patients undergoing spinal fusion surgery?
  7. Will I need any additional procedures or treatments in the future due to the spinal fusion with the Hartshill Horseshoe implant?
  8. How long can I expect the Hartshill Horseshoe implant to last in my spine before needing to be replaced or revised?
  9. What steps can I take to optimize my recovery and ensure the best possible outcome following spinal fusion with the Hartshill Horseshoe implant?
  10. Are there any specific lifestyle changes or restrictions I should follow after spinal fusion with the Hartshill Horseshoe implant to prevent complications or promote healing?

Reference

Authors: Choy WJ, Abi-Hanna D, Cassar LP, Hardcastle P, Phan K, Mobbs RJ. Journal: World Neurosurg. 2019 Sep;129:394-400. doi: 10.1016/j.wneu.2019.06.134. Epub 2019 Jun 27. PMID: 31254709