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. 2018 Jan-Mar;9(1):50-55.
doi: 10.4103/jcvjs.JCVJS_21_18.

The expandable transforaminal lumbar interbody fusion - Two years follow-up

Joseph Gamal Boktor  1 , Rhys D Pockett  2 , Navin Verghese  1
Affiliations

The expandable transforaminal lumbar interbody fusion - Two years follow-up

Joseph Gamal Boktor et al. J Craniovertebr Junction Spine. 2018 Jan-Mar.

Abstract

Study design: This was a retrospective, observational study.

Objectives: We hypothesize that the expandable transforaminal lumbar interbody fusion (TLIF) cage achieves satisfactory clinical outcomes while allowing for safe placement, improvement, and maintenance of foraminal and disc dimensions at 24 months postsurgery with low risk of cage migration, subsidence, and nerve injury.

Methods: TLIF with expandable cages was performed in 54 patients (62 levels) over a 24-month-period using open midline or minimally invasive surgery techniques with placement of Globus Caliber, Rise, or Altera expandable cages. All patients underwent clinical and radiological assessment at 6 weeks, 6 months, 1, and 2 years postoperatively. Clinical outcome was measured by Oswestry disability index (ODI), visual analog pain score for both back and leg (visual analog scores [VASs]). Radiological assessment was done by X-ray standing lateral position.

Results: There were significant clinical improvements in ODI, VAS leg, and VAS back at all postoperative time points. Disc height, foraminal height, focal Cobb angle, and global Cobb angle were significantly increased and maintained at all time points for 24 months (P < 0.001). Dural tear occurred in one patient (1.9%). There were neither intra- or postoperative neurological complications nor cage subsidence nor migration.

Conclusions: These preliminary results indicate that the use of an expandable interbody cage achieves good clinical outcomes by improving and maintaining foraminal dimensions and disc height with minimal complication rate.

Keywords: Back pain; expandable interbody cage; interbody fusion; transforaminal lumbar interbody fusion.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Cage insertion, (b) Cage distraction, (c) Compression on screws to restore lordosis
Figure 2
Figure 2
(a) Measuring variable angles and neural dimensions: (1) Red line: neuroforaminal height. (2) Blue line: Disc height. (3) Yellow line: Focal and Global Cobb angle, (b) Follow-up X-ray
Figure 3
Figure 3
Mean Oswestry disability index changes over 24-month follow-up
Figure 4
Figure 4
Mean visual analog score back pain and leg pain over 24-month follow-up
Figure 5
Figure 5
Disc height changes over 24 months
Figure 6
Figure 6
Neuroforaminal height changes over 24 months
Figure 7
Figure 7
Focal Cobb angle changes over 24 months
Figure 8
Figure 8
Global Cobb angle changes over 24 months
See this image and copyright information in PMC

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