Changes in the Lumbar Vertebral Segment Related to the Cage Position in Tlif Technique

Matos, Thiago Dantas; Fleury, Rodrigo Barra Caiado; Teixeira, Kelsen de Oliveira; Romero, Valéria; Defino, Helton Luíz Aparecido

doi:10.1590/1413-785220202802224215

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…Kwon et al 20 proposed that an interbody cage should be placed on the anterior part of the vertebral endplate to enhance stability and increase lordosis of the operated segment. A study on the basis of the lumbar polyurethane anatomical model concluded that posterior cage placement would increase the SLL 21 . This difference may be due to different research objects, research methods and implants.…”

Section: Introductionmentioning

confidence: 99%

Do Radiographic Results of Transforaminal Lumbar Interbody Fusion Vary with Cage Position in Patients with Degenerative Lumbar Diseases?

Ding

Tang

Zhang

et al. 2022

Orthopaedic Surgery

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Objective To investigate whether the radiographic results are affected by cage position in single‐level transforaminal lumbar interbody fusion (TLIF). Method Between January 2016 and June 2018, 130 patients (62 males and 68 females, average age: 55.28 ± 10.11 years) who underwent single‐level TLIF were analyzed retrospectively. Standing lateral radiographs of the lumbar spine were collected and evaluated preoperatively, postoperatively, and at the time of last follow‐up. Cage position in the fused segment was recorded using a central point ratio (CPR), which indicated the cage position. CPR is calculated by dividing the distance between the cage center point and the posterior extent of the superior endplate of the inferior vertebra by the length of the superior endplate of the inferior vertebra. Based on cage positions, the patients were divided into three groups: Anterior Group (n = 38); Middle Group (n = 68); and Posterior Group (n = 24). Segmental lumbar lordosis (SLL), foraminal height (FH), posterior disc height (PDH), and anterior disc height (ADH) were evaluated. A subanalysis was also performed on cage height within each group. Results The average follow‐up time of the patients was 35.20 ± 4.43 months. The mean values of CPR in Anterior Group, Middle Group, and Posterior Group were 0.64, 0.51, and 0.37, respectively. The FH, PDH, and ADH were significantly increased after TLIF in all groups (P < 0.05). There were significant differences in increase of SLL in Anterior Group (4.4°) and Middle Group (3.0°), but not in Posterior Group (0.3°). Furthermore, in the comparison of the three groups, the increase of SLL, FH, and PDH was statistically different (P < 0.05), while not for ADH (P > 0.05). The significant correlations in surgery were: CPR and ΔSLL (r = 0.584, P < 0.001), CPR and ΔFH (r = −0.411, P < 0.001), and CPR and ΔPDH (r = −0.457, P < 0.001). However, ADH had a positive correlation with cage height when the cage was located in anterior and middle of the endplate. Moreover, cage height had a positive correlation with SLL when the cage was located anteriorly and had a negative correlation with SLL when the cage was located posteriorly. FH and PDH both had a positive correlation with cage height in any cage position. Conclusion The cage located in different positions has different effects on radiographic results in single‐level TLIF. A thicker cage located anteriorly will gain maximum SLL and avoid the reduction of FH and PDH.

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Section: Introductionmentioning

confidence: 99%

Do Radiographic Results of Transforaminal Lumbar Interbody Fusion Vary with Cage Position in Patients with Degenerative Lumbar Diseases?

Ding

Tang

Zhang

et al. 2022

Orthopaedic Surgery

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“…Previous studies have shown that the cage height and position implanted in transforaminal lumbar interbody fusion (TLIF) are important [13,14]. However, there is no consensus in the cage proper positioning and height in LLIF.…”

Section: Introductionmentioning

confidence: 99%

Effects of the cage height and positioning on clinical and radiographic outcome of lateral lumbar interbody fusion: a retrospective study

Bian

Liu

et al. 2022

BMC Musculoskelet Disord

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Background The proper cage positioning and height in lateral lumbar interbody fusion (LLIF). This study evaluated their effects on clinical and radiographic outcome measures in patients undergoing LLIF. Methods This single-center retrospective study analyzed the characteristics and perioperative data of patients who underwent LLIF between January 2019 and December 2020. Radiographic (lumbar lordosis [LL], foraminal height, disc height [DH], segmental angle [SA], cross-sectional area [CSA] of thecal sac) and clinical (Oswestry Disability Index and Visual Analog Scale) outcomes were assessed preoperatively, postoperatively, and at the last follow-up. The effects of cage height and positioning on these parameters were also investigated. Results With a mean follow-up of 12.8 months, 47 patients with 70 operated level were analyzed. Data demonstrated that postsurgical clinical and radiographic outcome measures were significantly better than before surgery(P < 0.05). Cage height and positioning showed no significant difference with regarding to clinical outcome(P > 0.05). Subgroup analysis of the cage positioning showed that DH and SA were better restored by the final follow-up in patients with anteriorly placed cages than those with posteriorly placed cages (P < 0.05). Cages of posterior position showed significantly upgrading cage subsidence (P = 0.047). Cage height subgroup analysis showed that the preoperative forminal height, DH, and SA in the 11-mm cage group were significantly lower than in the 13-mm cage group; however, these parameters were comparable in the two groups postoperatively and at the final follow-up (P > 0.05). Furthermore, the postoperative and final follow-up degrees of DH, SA, and LL have improved in the 11-mm cage group more than the 13-mm cage group. The preoperative, postoperative, and final follow-up LL values in the 11-mm cage group were lower than in the 13-mm cage group(P < 0.01). Conclusions Cage height and positioning did not affect the clinical outcomes in the present study. Cages in anterior position showed better restoration in DH, SA and decreased the incidence of cage subsidence. A comparable radiographic outcome can be achieved by inserting an appropriate cage height based on preoperative radiography.

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Small Preoperative Dural Sac Cross-Sectional Area and Anteriorly Placed Fusion Cages Are Risk Factors for Indirect Decompression Failure after Oblique Lateral Interbody Fusion

Shan

Zhang

et al. 2022

World Neurosurgery

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Changes in the Lumbar Vertebral Segment Related to the Cage Position in Tlif Technique

Cited by 5 publications

References 19 publications

Do Radiographic Results of Transforaminal Lumbar Interbody Fusion Vary with Cage Position in Patients with Degenerative Lumbar Diseases?

Do Radiographic Results of Transforaminal Lumbar Interbody Fusion Vary with Cage Position in Patients with Degenerative Lumbar Diseases?

Effects of the cage height and positioning on clinical and radiographic outcome of lateral lumbar interbody fusion: a retrospective study

Small Preoperative Dural Sac Cross-Sectional Area and Anteriorly Placed Fusion Cages Are Risk Factors for Indirect Decompression Failure after Oblique Lateral Interbody Fusion

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