Transforaminal lumbar interbody fusion using banana-shaped and straight cages: meta-analysis of clinical and radiological outcomes

Sebaaly, Amer; Kreichati, Gaby; Tarchichi, Jean; Kharrat, Khalil; Daher, Mohammad

doi:10.1007/s00586-023-07797-z

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…A previous meta-analysis showed that straight bullet cages provided better recovery of DH and SL after TLIF compared to banana-shaped cages [ 10 ]. However, the present study is contrary to the results of the previous study.…”

Section: Discussionmentioning

confidence: 99%

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Comparing Outcomes of Banana-Shaped and Straight Cages in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis

Lin,

He,

Nan

et al. 2024

Neurospine

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Objective: This meta-analysis aims to refine the understanding of the optimal choice between different cage shapes in transforaminal lumbar interbody fusion (TLIF) by systematically comparing perioperative data, radiological outcomes, clinical results, and complications associated with banana-shaped and straight bullet cages.Methods: A meticulous literature search encompassing PubMed, Embase, Scopus, Web of Science, China Knowledge Network, and Wanfang Data was executed up to October 5, 2023. Inclusion criteria focused on studies comparing banana-shaped and straight bullet cages in TLIF. The quality of included studies was assessed using appropriate tools such as the Newcastle-Ottawa Scale (NOS) for nonrandomized studies. Rigorous evaluations were performed for radiographic outcomes, including disc height (DH), segmental lordosis (SL), lumbar lordosis (LL), subsidence, and fusion rates. Clinical outcomes were meticulously evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI), and complications.Results: The analysis incorporated 7 studies, involving 573 patients (297 with banana-shaped cages, 276 with straight cages), all with NOS ratings exceeding 5 stars. No statistically significant differences were observed in operative time, blood loss, or hospitalization between the 2 cage shapes. Banana-shaped cages exhibited greater changes in DH (p = 0.001), SL (p = 0.02), and LL (p = 0.01). Despite statistically higher changes in ODI for straight cages (26.33, p < 0.0001), the actual value remained similar to banana-shaped cages (26.15). Both cage types demonstrated similar efficacy in VAS, complication rates, subsidence, and fusion rates.Conclusion: Although banana-shaped cages can excel in restoring DH, SL, and LL, straight bullet cages can provide comparable functional improvements, pain relief, and complication rates.

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Section: Discussionmentioning

confidence: 99%

“…Numerous studies have explored the advantages and disadvantages of these different cage shapes, with proponents and sceptics on both sides [ 8 - 10 ]. Both cage types aim to maximize endplate contact and minimize risk of subsidence.…”

Section: Introductionmentioning

confidence: 99%