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A Comparison of 2 Cage Sizes in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion – Lumbar Fusion

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The article is a retrospective study that compared fusion and subsidence rates and clinical outcomes using different-sized static PEEK cages in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion (BE-TLIF). The study found that using a larger cage in BE-TLIF led to similar patient-reported outcome measures, faster fusion rates, and a lower risk of subsidence compared to using a smaller cage. The study included patients who underwent BE-TLIF for degenerative and isthmic spondylolisthesis and assessed them using visual analog scale (VAS) for back and leg symptoms, Oswestry disability index (ODI), and radiographic imaging. The results showed that patients with the larger cage had a higher fusion ratio at 1 year and lower incidence of subsidence compared to patients with the smaller cage. The study concludes that BE-TLIF using a larger cage can be performed safely with favorable outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated day surgery hospital in the world

Published article

: BE-TLIF using a larger cage can be performed safely with similar patient-reported outcome measures with a faster fusion rate with less subsidence risk.

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Clin Spine Surg. 2024 Apr 23. doi: 10.1097/BSD.0000000000001633. Online ahead of print. ABSTRACT STUDY DESIGN: Retrospective study. OBJECTIVE: This study compared the fusion and subsidence rate and clinical outcomes when using different-sized static PEEK cages in BE-TLIF. SUMMARY OF BACKGROUND DATA: Biportal endoscopic techniques for transforaminal lumbar interbody fusion (BE-TLIF) have been shown to have,

Clin Spine Surg. 2024 Apr 23. doi: 10.1097/BSD.0000000000001633. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective study.

OBJECTIVE: This study compared the fusion and subsidence rate and clinical outcomes when using different-sized static PEEK cages in BE-TLIF.

SUMMARY OF BACKGROUND DATA: Biportal endoscopic techniques for transforaminal lumbar interbody fusion (BE-TLIF) have been shown to have similar clinical and fusion outcomes with faster clinical recovery in comparison to tubular surgery. Subsidence of the interbody, however, could be a complication.

METHODS: Patients who underwent 1 or 2 level BE-TLIF for degenerative and isthmic spondylolisthesis between January 2019 and January 2022 were included. A 32×10 mm cage (group A) and a 40×15 mm cage (group B) were compared. The visual analog scale (VAS) for back and leg symptoms, and Oswestry disability index (ODI) were collected. Plain radiographs and computed tomography assessed fusion and subsidence at a minimum of 12 months.

RESULTS: Of the 69 enrolled patients, 39 group A patients (51 levels) and 30 group B patients (32 levels) were compared. The operation time per level was 123 ± 15.8 and 138 ± 10.5 minutes per fusion level in groups A and B, respectively (P < 0.05). ODI improved from 64.8 ± 6.2 to 15.7 ± 7.1 in group A and from 65.3 ± 5.6 to 15.1 ± 6.3 in group B at the final follow-up (P < 0.05). VAS leg and back score improvement between the groups did not differ; however, the 3-month postoperative VAS back improvement was significantly higher in group B. The final fusion rate at the final follow-up did not significantly differ; however, the fusion ratio at 1 year was higher in group B (P < 0.05). Subsidence occurred in 5 cases (9.8%) in group A and none in group B (P < 0.05).

: BE-TLIF using a larger cage can be performed safely with similar patient-reported outcome measures with a faster fusion rate with less subsidence risk.

LEVEL OF STUDY: III.

PMID:38650073 | DOI:10.1097/BSD.0000000000001633

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A Comparison of 2 Cage Sizes in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion

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Clin Spine Surg. 2024 Apr 23. doi: 10.1097/BSD.0000000000001633. Online ahead of print. ABSTRACT STUDY DESIGN: Retrospective study. OBJECTIVE: This study compared the fusion and subsidence rate and clinical outcomes when using different-sized static PEEK cages in BE-TLIF. SUMMARY OF BACKGROUND DATA: Biportal endoscopic techniques for transforaminal lumbar interbody fusion (BE-TLIF) have been shown to have

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