ArticleQuantitative imaging in medicine and surgery2025
Personalized and precise prediction of cage width and implantation angle in transforaminal lumbar interbody fusion: an image analysis of combined application of CT and Surgimap.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Transforaminal lumbar interbody fusion (TLIF) is a commonly used method for treating degenerative diseases of the lumbar spine, but little attention has been paid to the relevant details of its cage. The aim of this study was to investigate and analyze the implantation angle and the maximum selectable width of the cage during TLIF surgery. Methods: A retrospective analysis was conducted on computed tomography (CT) images of patients who underwent single-level TLIF surgery (L4/5) with cages of different widths (50 cases of 10 mm cages and 43 cases of 12 mm cages). Surgimap software was utilized for measurements and the position of the exiting nerve root, the maximum initial angle for cage implantation into the intervertebral space, and the maximum cage width were investigated. Results: During TLIF surgery with pedicle screws and rods in place, the maximum initial implantation angle was 28.56°±4.65° for 10 mm-wide cages and 27.26°±5.34° for 12 mm-wide cages. Theoretically, a cage with a maximum width of 17.56±2.53 mm can be used. The distance from the exiting nerve root to the midline was 19.92±2.62 mm on the left side and 20.85±2.99 mm on the right side. Without the restriction of pedicle screws and rods, the maximum initial implantation angle of the cage was approximately 60°. Conclusions: CT images were analyzed using Surgimap software, revealing that the cage width and implantation angle can be effectively evaluated, facilitating personalized and precise surgical planning.
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