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

Choi, Won-Suh; Kim, Jin-Sung; Hur, Jung‐Woo; Seong, Ji-Hoon

doi:10.1093/neuros/nyx212

Cited by 60 publications

(36 citation statements)

References 42 publications

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“…Bilateral facetectomy and TLIF with banana-shaped cages were previously reported to increase segmental angles [35,36]. However, there may be some debates because other studies observed no significant improvement in segmental angles after TLIF and no difference according to the TLIF cage type [32,33].…”

Section: Discussionmentioning

confidence: 98%

“…The greater mean postoperative LL in the OLIF51 group than in the TLIF51 group seemed to be due to the significant increase in disc angle at the L5-S1 level because the L5-S1 level contributes largely to the lumbar lordosis [31]. During OLIF at L5-S1, the anterior disc space was opened widely as in anterior lumbar interbody fusion (ALIF), which helped to create a larger disc angle than that with TLIF [32][33][34]. Since TLIF was introduced in 1982, it was developed as a MIS technique [12,33].…”

Section: Discussionmentioning

confidence: 99%

“…During OLIF at L5-S1, the anterior disc space was opened widely as in anterior lumbar interbody fusion (ALIF), which helped to create a larger disc angle than that with TLIF [32][33][34]. Since TLIF was introduced in 1982, it was developed as a MIS technique [12,33]. We had been mainly used TLIF at L5-S1 level before the introduction of OLIF51.…”

Section: Discussionmentioning

confidence: 99%

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Correction of marked sagittal deformity with circumferential minimally invasive surgery using oblique lateral interbody fusion in adult spinal deformity

Park

Kim

et al. 2020

J Orthop Surg Res

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Background: Spinal surgery performed entirely with minimally invasive surgery is referred to as circumferential MIS (cMIS). However, cMIS still has a limited sagittal correction capability for adult spinal deformity (ASD) with a marked sagittal deformity. We investigated the effectiveness of cMIS using oblique lateral interbody fusion (OLIF) and percutaneous posterior spine fixation in correcting marked sagittal deformity. Methods: This study retrospectively evaluated 23 patients with ASD with marked sagittal deformity who underwent cMIS using OLIF without osteotomy and were followed-up for at least 24 months (whole group). The whole group was divided into the following two groups according to the type of interbody fusion at L5-S1: the OLIF51 group (n = 13) underwent OLIF at L1-L5 and L5-S1 and the TLIF51 group (n = 10) underwent OLIF at L1-L5 and transforaminal lumbar interbody fusion (TLIF) at L5-S1. Results: Sagittal vertebral axis (SVA; 125.7 vs. 29.5 mm, p < 0.001), lumbar lordosis (LL; 18.2°vs. 51.7°, p < 0.001), and pelvic incidence-LL mismatch (PI-LL, 35.5°vs. 5.3°) significantly improved postoperatively in the whole group. The OLIF51 group showed significantly higher postoperative LL than the TLIF51 group (55.5°vs. 46.9°, p < 0.001). OLIF yielded a significantly greater disc angle at L5-S1 than did TLIF (18.4°vs. 6.9°, p < 0.001). Proximal junctional kyphosis occurred significantly earlier in the OLIF51 group than in the TLIF51 group (8.6 vs. 26.3 months, p < 0.001). Conclusion: Successful sagittal correction in ASD patients with marked sagittal deformity was achieved with cMIS using OLIF. OLIF at L5-S1 showed a synergistic effect in sagittal deformity correction by cMIS.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Correction of marked sagittal deformity with circumferential minimally invasive surgery using oblique lateral interbody fusion in adult spinal deformity

Park

Kim

et al. 2020

J Orthop Surg Res

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“…By comparing several level fusions, the benefits of TLIF would be emphasized, such as in elderly patients who require correction surgery for degenerative scoliosis using the multilevel interbody fusion that the low invasiveness of surgery including the decrease of blood loss and operative time would be essential to avoid the serious perioperative complication that affects the general condition 22,23) . The boomerang-shaped cages could be used for not only long fusion surgery but also minimally invasive surgery (MIS), which has recently been noticed as the new less invasive technique 24,25) . In our future study, comparison of surgical results between MIS technique and open procedure would be investigated for the further application of TLIF.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Transforaminal Lumbar Interbody Fusion Using the Boomerang-Shaped Cage with Traditional Posterior Lumbar Interbody Fusion for Lumbar Spondylolisthesis

Ishihara¹,

Morishita²,

Miyaki³

et al. 2019

Spine Surg Relat Res

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Introduction: This study aimed to compare the clinical and radiological results of transforaminal lumbar interbody fusion (TLIF) with a boomerang-shaped cage and traditional posterior lumbar interbody fusion (PLIF) according to fused level and elucidate whether TLIF could replace PLIF at all lumbar levels. Methods: The study investigated 128 patients with lumbar spondylolisthesis who underwent a single-level TLIF or traditional PLIF. Intraoperative blood loss, operative time, and recovery rate were analyzed. Percent slip, disc height, and local lordosis at the fused level were measured using X-ray images from preoperation to the final follow-up. Results: No significant differences in recovery rate were observed at any level. The operative time and intraoperative blood loss were significantly less in the TLIF group at the L4/5 and L5/S1 levels. There were no significant differences in disc height or local lordosis at the L3/4 and L4/5 levels, and a satisfactory level of maintenance after the operation was achieved in both groups. However, at the L5/S1 level, postoperative maintenance after TLIF could not be achieved, and the obtained disc height and local lordosis in TLIF significantly decreased. Conclusions: Compared with traditional PLIF, TLIF was a less invasive procedure with a shorter operative time and lesser blood loss. TLIF could obtain similar local lordosis and disc height as PLIF at the L3/4 and L4/5 levels. At the L5/S1 level, the postoperative maintenance of local lordosis and disc height after TLIF was inferior to that after PLIF. On the basis of our results, we do not recommend performing TLIF at only the L5/S1 level.

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“…The authors found a significant greater change of DH and SL in the banana-shaped group. [ 17 ] Moreover, they found more subsidence rates in the banana-shaped group. In our data, we measured preoperatively a SLA of 19.6° (SD 8.9) in the banana group.…”

Section: Discussionmentioning

confidence: 99%

Transforaminal lumbar interbody fusion with expandable cages: Radiological and clinical results of banana-shaped and straight implants

Tassemeier

Haversath

Jäger

2018

J Craniovert Jun Spine

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Purpose:Expandable titanium transforaminal lumbar interbody fusion (TLIF) devices are a relatively new group of implants allowing restoration of lumbar lordosis (LL) and thus improvement of sagittal alignment. The purpose of our study is to compare clinical and radiological results of two different expandable TLIF devices.Materials and Methods:In a retrospective study, patients who underwent TLIF surgery with a banana-shaped or straight TLIF cage in our spine center were analyzed. Primary outcome was change of disc height (DH), segmental lordosis angle (SLA), and lumbar lordotic angle (LLA). Moreover, basic patients parameters and cage subsidence were evaluated.Results:Sixty-one patients were studied (33 banana-shaped and 28 straight cages). DH changed in the banana group from 4.8 mm (standard deviation SD 2.5) to 10.4 (SD 2.4) and in the straight cage group from 6.2 mm (SD 2.5) to 9.6 mm (SD 1.7). The difference was statistically significant (P = 0.03). In addition, SLA correction was higher in the banana group with 5.8° (SD 5.0)–3.7° (SD 3.6), but not significant. LLA improved in the straight group with 5.2 (SD 6.4) compared to 3.7° (SD 5.8) in the banana group. We found subsidence in four patients (6.6%) in the banana-shaped group and nine cases (14.8%) in the other group.Conclusions:Expandable titanium implants show similar improvements in restoring segmental and global lordosis. Banana-shaped expandable cages offer higher potency restoring the intervertebral DH and show less rates of subsidence compared to straight expandable cages.

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

Abstract: Our preliminary outcomes suggest that the subsidence rate may be higher using banana-shaped cages in MIS-TLIF, possibly due to their more medial final position.

Cited by 60 publications

References 42 publications

Correction of marked sagittal deformity with circumferential minimally invasive surgery using oblique lateral interbody fusion in adult spinal deformity

Correction of marked sagittal deformity with circumferential minimally invasive surgery using oblique lateral interbody fusion in adult spinal deformity

Comparison of Transforaminal Lumbar Interbody Fusion Using the Boomerang-Shaped Cage with Traditional Posterior Lumbar Interbody Fusion for Lumbar Spondylolisthesis

Transforaminal lumbar interbody fusion with expandable cages: Radiological and clinical results of banana-shaped and straight implants

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