Question for RNs who scrub and circulate neuro and/or ortho; also RNFAs

Specialties Operating Room


Does anybody have any literature on indications for, contraindications to, and medical and nursing (intraop and postop) standards of care for patients having spinal fusins using vertebral body cages? I have worked with 2 neurosurgeons who did them; normally, for thoraco-lumbar fusions or lumbar fusions for spinal spodylosis. The ones we used were by Sofmore(sp?) Danek (Used to be just Danek.) I am sure there must be other manufacturers.

When I've seen them done, they were always used in conjunction with allograft (usually banked femoral dowels) or autograft harvested from the iliac crest.

I have NEVER seen them done for a C-spine fusion; can they be used for a posterior C-spine fusion? In fact, in a lot of places where I have worked, the neurosurgeons don't do AC or PC fusions anymore; they say the results aren't any better that a straightforward cervical laminectomy with discectomy. But thats a whole 'nother topic....

When I have seen posterior cervical spinal fusions done recently, we used Orion plates and screws, or Synthes spinal plates and screws, or, sometimes, Dall Miles cable. I think that (Dall Miles cable) is indicated for severe instability.

I would like to hear other nurses' experience as to the trends in other areas of the country. If anybody has any idea where to get various vendors' product literature and research results as to use of cages in particulasr, please let me know, preferably privately, but on the BB if it seems others are interested.

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