Elimination of Subsidence with 26mm Wide Cages in Extreme Lateral Interbody Fusion.

Related Articles

Elimination of Subsidence with 26mm Wide Cages in Extreme Lateral Interbody Fusion.

World Neurosurg. 2017 May 16;:

Authors: Lang G, Navarro-Ramirez R, Gandevia L, Hussain I, Nakhla J, Zubkov M, Härtl R

Abstract
BACKGROUND: Extreme lateral interbody fusion (ELIF) has gained popularity as minimally invasive technique for indirect decompression. However, graft subsidence potentially threatens the long-term success of ELIF. The aim of the study was to evaluate whether 26mm wide cages can eliminate subsidence and subsequent loss of decompression in ELIF.
METHODS: Patients undergoing ELIF surgery using a 26mm wide cage were analyzed retrospectively. Patient demographics and peri-operative data for radiographic and clinical outcomes were recorded. Radiographic parameters included regional sagittal lumbar lordosis, foraminal and disc height. Clinical parameters were evaluated using Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS). Subsidence of 26mm wide cages was compared to previous outcome of patients undergoing ELIF utilizing 18mm and 22mm wide cages.
RESULTS: 21 patients containing a total of 28 spinal segments were analyzed. Radiographic outcome measures such as disc and foraminal height revealed significant improvement at follow-up compared to before surgery (P=0.001). Postoperative to last follow-up cage subsidence translated into 0.34±0.26mm and -0.55±0.64mm in disc and foraminal height loss, respectively. Patients having a 26mm wide cage experienced less subsidence by means of disc (26mm vs. 18/22mm: P≤ 0.05) and foraminal height loss (26mm vs. 18mm: P=0.005; 26mm vs. 22mm: P=0.208) compared to patients receiving 18mm / 22mm wide cages.
CONCLUSIONS: 26mm wide cages almost eliminate cage subsidence in ELIF. Compared to 18mm and 22mm wide cages, 26mm wide cages significantly reduce cage subsidence in ELIF at mid-term follow-up. 26mm wide cages should be utilized in ELIF to achieve sustained indirect decompression.

PMID: 28526641 [PubMed - as supplied by publisher]

http://ift.tt/2qKzKwx