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. 2020 Aug;14(4):518-526.
doi: 10.14444/7068. Epub 2020 Jul 31.

Two-Year Clinical and Radiographic Outcomes of Expandable Interbody Spacers Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Study

Choll Kim  1 , Dan S Cohen  1 , Mark D Smith  1 , Gary A Dix  1 , Ingrid Y Luna  1 , Gita Joshua  1
Affiliations

Two-Year Clinical and Radiographic Outcomes of Expandable Interbody Spacers Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Study

Choll Kim et al. Int J Spine Surg. 2020 Aug.

Abstract

Background: The advantages of minimally invasive surgery for transforaminal lumbar interbody fusion (MIS TLIF) are well documented and include decreased blood loss, shorter length of hospital stay, and reduced perioperative costs. Clinical evidence for the use of expandable interbody spacers in conjunction with MIS TLIF, however, is scarce. This study sought to examine the clinical and radiographic outcomes of patients undergoing MIS TLIF with an expandable spacer.

Methods: Forty patients from 4 institutions who underwent MIS TLIF with an expandable spacer were included in this study and followed for 24 months. Investigator assessment of the surgical technique was reported. Patient self-reported outcomes included Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Short Form 36 (SF-36) physical and mental component scores. Disc height, foraminal height, segmental and lumbar lordosis, and fusion were also assessed.

Results: Investigators reported that intraoperative insertion, impaction, number of passes through the neural structures, and fit were better with an expandable spacer than a static spacer. Significant improvements in VAS, ODI, and SF-36 were reported as early as 6 weeks postoperatively and maintained through 24 months. Mean intervertebral and foraminal heights improved significantly from the preoperative time interval to as early as 6 weeks postoperatively and maintained through 24 months. There were no cases of spacer migration, subsidence, or collapse.

Conclusions: The use of an expandable interbody spacer in combination with MIS TLIF resulted in positive investigator assessments, immediate and progressive symptom relief, significant radiographic improvements, and no spacer-related complications.

Keywords: DDD; TLIF; expandable interbody spacer; impaction; lumbar fusion.

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Conflict of interest statement

Disclosures and COI: Dr Kim has nothing to disclose. Drs Cohen, Smith, and Dix are consultants for and receive royalties and consulting fees from a company involved in the manufacture of a device examined in this study. Ms Luna is a former salaried employee of a company involved in the manufacture of a device examined in this study. Ms Joshua is a salaried employee of a company involved in the manufacture of a device examined in this study. All authors approved the final manuscript for submission for publication.

Figures

Figure 1
Figure 1
Average Oswestry Disability Index (ODI) scores.
Figure 2
Figure 2
Average Short Form 36 (SF-36) health status scores.
Figure 3
Figure 3
Average disc and foraminal heights.
Figure 4
Figure 4
Bony fusions 24 months postoperative.
See this image and copyright information in PMC

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