ArticleInternational journal of spine surgery2025
Comparison of 1-Year Clinical and Radiographic Outcomes Between 2 Expandable Cage Designs in Navigation-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion.
Article in International journal of spine 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
backgroundMinimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) often struggles to provide sufficient lordotic alignment restoration. The choice of cage design, including its height and lordotic angle, is critical. This study compares 2 expandable cage designs in MIS-TLIF: one that increases only disc height (group H) and another that expands both height and lordosis (group HL).
methodsSeventy-five patients who underwent navigation-assisted MIS-TLIF using expandable cages were reviewed. These included 35 cases using expandable cages that increase only height (group H) and 40 cases using cages that expand both height and lordosis (group HL). Clinical outcomes, including a numeric rating scale of back pain, leg pain, and Oswestry Disability Index and radiographic parameters, including disc height, lordotic angle, subsidence, and fusion rates, were evaluated.
resultsBoth groups showed significant improvements in clinical outcomes, with no differences between groups. Postoperative disc and foraminal height increased significantly. At the 1-year follow-up, group HL demonstrated greater improvements in segmental lordosis (4.0° ± 3.3° vs 1.9° ± 5.4°,
conclusionThis study demonstrates that MIS-TLIF with expandable cages designed to increase lordosis offers superior improvement in segmental lordosis at the 1-year follow-up, compared with expandable cages that only expand disc height. Both cage designs achieved high fusion rates and showed similar clinical outcomes. CLINICAL RELEVANCE: The surgeon's experience in the use of expandable cages is a critical factor in reducing the risk of cage subsidence, a complication that may adversely affect clinical outcomes. LEVEL OF EVIDENCE: 3:
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