Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Banana-Shaped and Straight Cages: Radiological and Clinical Results from a Prospective Randomized Clinical Trial

Neurosurgery
Won-Suh ChoiJi-Hoon Seong

Abstract

In minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), cage type and position play important roles in fusion achievement and sagittal alignment correction. However, no prospective randomized comparison of the results using different types of cage has been reported to date. To compare the radiological and clinical outcomes of unilateral MIS-TLIF using 2 types of cage. All candidates for single-level MIS-TLIF were randomized into banana-shaped cage and straight-cage groups. Plain radiographs and computed tomography scans were used for assessment of cage positions, fusion status, disc height, segmental lordotic angle, cage subsidence, and pelvic parameters. Clinical outcome was assessed using visual analog scale and Oswestry Disability Index scores. Forty-four and 40 consecutive patients were operated on using banana-shaped and straight cages, respectively. Cage position was more anterior and lateral in the straight-cage group and more medial and posterior in the banana-shaped cage group. Solid fusion was achieved in 95.2% and 96.6% of the 2 groups, respectively, at 12 mo. The change in disc height and segmental lordotic angle postoperatively was significantly greater in the banana-shaped cage group. The incidenc...Continue Reading

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Citations

Jun 1, 2018·Minimally Invasive Surgery·Kevin Y Chang, Wellington K Hsu
Mar 8, 2019·Clinical Spine Surgery : a Spine Publication·Nathan WandermanMelvin D Helgeson
Jun 17, 2020·World Neurosurgery·Parthik D PatelAlexander R Vaccaro

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