Effect of Cage Material and Size on Fusion Rate and Subsidence Following Biportal Endoscopic Transforaminal Lumbar Interbody Fusion.

IF 3.8 2区 医学 Q1 CLINICAL NEUROLOGY Neurospine Pub Date : 2024-09-01 Epub Date: 2024-09-30 DOI:10.14245/ns.2448244.122
Ki-Han You, Samuel K Cho, Jae-Yeun Hwang, Sun-Ho Cha, Min-Seok Kang, Sang-Min Park, Hyun-Jin Park
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Abstract

Objective: Biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF) is an emerging, minimally invasive technique performed under biportal endoscopic guidance. However, concerns regarding cage subsidence and sufficient fusion during BE-TLIF necessitate careful selection of an appropriate interbody cage to improve surgical outcomes. This study compared the fusion rate, subsidence, and other radiographic parameters according to the material and size of the cages used in BE-TLIF.

Methods: In this retrospective cohort study, patients who underwent single-segment BE-TLIF between April 2019 and February 2023 were divided into 3 groups: group A, regular-sized three-dimensionally (3D)-printed titanium cages; group B, regular-sized polyetheretherketone cages; and group C, large-sized 3D-printed titanium cages. Radiographic parameters, including lumbar lordosis, segmental lordosis, anterior and posterior disc heights, disc angle, and foraminal height, were measured before and after surgery. The fusion rate and severity of cage subsidence were compared between the groups.

Results: No significant differences were noted in the demographic data or radiographic parameters between the groups. The fusion rate on 1-year postoperative computed tomography was comparable between the groups. The cage subsidence rate was significantly lower in group C than in group A (41.9% vs. 16.7%, p=0.044). The severity of cage subsidence was significantly lower in group C (0.93±0.83) than in groups A (2.20±1.84, p=0.004) and B (1.79±1.47, p=0.048).

Conclusion: Cage materials did not affect the 1-year postoperative outcomes of BE-TLIF; however, subsidence was markedly reduced in large cages. Larger cages may provide more stable postoperative segments.

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双ortal 内窥镜经椎间孔腰椎椎体融合术后保持架材料和尺寸对融合率和下沉的影响
目的:双ortal内窥镜经椎间孔腰椎椎体间融合术(BE-TLIF)是一种新兴的微创技术,在双ortal内窥镜引导下进行。然而,BE-TLIF术中的椎间笼下沉和充分融合问题令人担忧,因此有必要谨慎选择合适的椎间笼以改善手术效果。本研究根据 BE-TLIF 使用的椎间孔笼的材料和尺寸,比较了融合率、下沉和其他影像学参数:在这项回顾性队列研究中,2019年4月至2023年2月期间接受单节段BE-TLIF的患者被分为3组:A组,常规尺寸的三维(3D)打印钛椎间套管;B组,常规尺寸的聚醚醚酮椎间套管;C组,大尺寸的3D打印钛椎间套管。手术前后测量了腰椎前凸、节段前凸、椎间盘前后高度、椎间盘角度和椎间孔高度等影像学参数。比较了两组患者的融合率和椎弓根下沉的严重程度:结果:两组的人口统计学数据和放射学参数无明显差异。两组术后一年的计算机断层扫描融合率相当。C 组椎笼下沉率明显低于 A 组(41.9% 对 16.7%,P=0.044)。C组(0.93±0.83)明显低于A组(2.20±1.84,P=0.004)和B组(1.79±1.47,P=0.048):笼体材料对BE-TLIF术后1年的疗效没有影响;但是,大型笼体明显减少了下沉。较大的笼子可能会提供更稳定的术后节段。
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来源期刊
Neurospine
Neurospine Multiple-
CiteScore
5.80
自引率
18.80%
发文量
93
审稿时长
10 weeks
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