Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion
Study Design Retrospective cohort study. Purpose To compare the radiographic and clinical outcomes of static versus expandable interbody cages in transforaminal lumbar interbody fusion using minimally invasive surgery (MIS-TLIF). Overview of Literature Expandable interbody cages may potentially impr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2023-02-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2021-0486.pdf |
| _version_ | 1797835752264957952 |
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| author | Jonathan Andrew Ledesma Mark J. Lambrechts Azra Dees Terence Thomas Cannon Greco Hiranaka Mark Faisal Kurd Kris E. Radcliff David Greg Anderson |
| author_facet | Jonathan Andrew Ledesma Mark J. Lambrechts Azra Dees Terence Thomas Cannon Greco Hiranaka Mark Faisal Kurd Kris E. Radcliff David Greg Anderson |
| author_sort | Jonathan Andrew Ledesma |
| collection | DOAJ |
| description | Study Design Retrospective cohort study. Purpose To compare the radiographic and clinical outcomes of static versus expandable interbody cages in transforaminal lumbar interbody fusion using minimally invasive surgery (MIS-TLIF). Overview of Literature Expandable interbody cages may potentially improve radiographic and clinical outcomes following MIS-TLIF compared to static pages, but at a potentially higher cost and increased rates of subsidence. Methods A retrospective chart review of 1- and 2-level MIS-TLIFs performed from 2014 to 2020 was reviewed. Radiographic measurements were obtained preoperatively, 6 weeks postoperatively, and at final follow-up. Patient-reported outcome measures (PROMs) including the Oswestry Disability Index, Visual Analog Scale (VAS) back, and VAS leg were evaluated. Multivariate linear regression analysis determined the effect of cage type on the change in PROMs, controlling for demographic characteristics. Alpha was set at 0.05. Results A total of 221 patients underwent MIS-TLIF including 136 static and 85 expandable cages. Expandable cages had significantly greater anterior (static: 11.41 mm vs. expandable: 13.11 mm, p<0.001) and posterior disk heights (static: 7.22 mm vs. expandable: 8.11 mm, p<0.001) at 1-year follow-up. Expandable cages offered similar improvements in segmental lordosis at 6 weeks (static: 1.69° vs. expandable: 2.81°, p=0.243), but segmental lordosis was better maintained with expandable cages leading to significant differences at 1-year follow-up (static: 0.86° vs. expandable: 2.45°, p=0.001). No significant differences were noted in total complication (static: 12.5% vs. expandable: 16.5%, p=0.191) or cage subsidence rates (static: 19.7% vs. expandable: 22.4%, p=0.502) groups at 1-year follow-up. Conclusions Expandable devices provide greater improvements in radiographic measurements including anterior disk height, posterior disk height, and segmental lordosis, but this did not lead to significant improvements in PROMs, complication rates, subsidence rates, or subsidence distance. |
| first_indexed | 2024-04-09T14:58:41Z |
| format | Article |
| id | doaj.art-7784f0c347624a3f92905f8f1b490d10 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-09T14:58:41Z |
| publishDate | 2023-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-7784f0c347624a3f92905f8f1b490d102023-05-01T23:47:38ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-02-01171617410.31616/asj.2021.04861455Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody FusionJonathan Andrew Ledesma0Mark J. Lambrechts1Azra Dees2Terence Thomas3Cannon Greco Hiranaka4Mark Faisal Kurd5Kris E. Radcliff6David Greg Anderson7Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USAStudy Design Retrospective cohort study. Purpose To compare the radiographic and clinical outcomes of static versus expandable interbody cages in transforaminal lumbar interbody fusion using minimally invasive surgery (MIS-TLIF). Overview of Literature Expandable interbody cages may potentially improve radiographic and clinical outcomes following MIS-TLIF compared to static pages, but at a potentially higher cost and increased rates of subsidence. Methods A retrospective chart review of 1- and 2-level MIS-TLIFs performed from 2014 to 2020 was reviewed. Radiographic measurements were obtained preoperatively, 6 weeks postoperatively, and at final follow-up. Patient-reported outcome measures (PROMs) including the Oswestry Disability Index, Visual Analog Scale (VAS) back, and VAS leg were evaluated. Multivariate linear regression analysis determined the effect of cage type on the change in PROMs, controlling for demographic characteristics. Alpha was set at 0.05. Results A total of 221 patients underwent MIS-TLIF including 136 static and 85 expandable cages. Expandable cages had significantly greater anterior (static: 11.41 mm vs. expandable: 13.11 mm, p<0.001) and posterior disk heights (static: 7.22 mm vs. expandable: 8.11 mm, p<0.001) at 1-year follow-up. Expandable cages offered similar improvements in segmental lordosis at 6 weeks (static: 1.69° vs. expandable: 2.81°, p=0.243), but segmental lordosis was better maintained with expandable cages leading to significant differences at 1-year follow-up (static: 0.86° vs. expandable: 2.45°, p=0.001). No significant differences were noted in total complication (static: 12.5% vs. expandable: 16.5%, p=0.191) or cage subsidence rates (static: 19.7% vs. expandable: 22.4%, p=0.502) groups at 1-year follow-up. Conclusions Expandable devices provide greater improvements in radiographic measurements including anterior disk height, posterior disk height, and segmental lordosis, but this did not lead to significant improvements in PROMs, complication rates, subsidence rates, or subsidence distance.http://www.asianspinejournal.org/upload/pdf/asj-2021-0486.pdfspineminimally invasivefusionexpandableradiographic |
| spellingShingle | Jonathan Andrew Ledesma Mark J. Lambrechts Azra Dees Terence Thomas Cannon Greco Hiranaka Mark Faisal Kurd Kris E. Radcliff David Greg Anderson Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion Asian Spine Journal spine minimally invasive fusion expandable radiographic |
| title | Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion |
| title_full | Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion |
| title_fullStr | Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion |
| title_full_unstemmed | Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion |
| title_short | Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion |
| title_sort | static versus expandable interbody fusion devices a comparison of 1 year clinical and radiographic outcomes in minimally invasive transforaminal lumbar interbody fusion |
| topic | spine minimally invasive fusion expandable radiographic |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2021-0486.pdf |
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