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Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques.

Rice JW, Sedney CL, Daffner SD, Arner JW, Emery SE, France JC - Global Spine J (2015)

Bottom Line: Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed.Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001).Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Marshall University, Huntington, West Virginia, United States.

ABSTRACT
Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. Results One hundred one patients were included in the study. Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001). Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes.

No MeSH data available.


(A) Anteroposterior and lateral radiograph demonstrating anterior placement of the kidney-shaped interbody cage. (B) Anteroposterior and lateral radiograph demonstrating placement of the straight interbody cage.
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FI1500062-2: (A) Anteroposterior and lateral radiograph demonstrating anterior placement of the kidney-shaped interbody cage. (B) Anteroposterior and lateral radiograph demonstrating placement of the straight interbody cage.

Mentions: The procedure for the c-TLIF group began by placing autogenous local bone in the disk space behind the ALL. The curved spacer was then placed into the disk space. The spacer was worked around the periphery of the disk space, moving toward its anterior aspect. Final impaction was performed until the spacer abutted the cancellous bone graft and ALL, with its long axis oriented in a medial-lateral direction (Fig. 2A). The TLIF group, likewise, received autogenous graft impacted behind the ALL. The graft used was a straight, rectangular cage with a bullet nose that aids in entering the disk space. The graft was placed in an oblique fashion toward the midline, as anteriorly as possible within the disk space. No cases received two implants at the same level. Both groups received pedicle screw fixation for stabilization of the fusion construct and posterolateral bone grafting (Fig. 2B). Compression along the pedicle screw/rod construct was performed in all cases to improve the sagittal alignment for both groups.


Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques.

Rice JW, Sedney CL, Daffner SD, Arner JW, Emery SE, France JC - Global Spine J (2015)

(A) Anteroposterior and lateral radiograph demonstrating anterior placement of the kidney-shaped interbody cage. (B) Anteroposterior and lateral radiograph demonstrating placement of the straight interbody cage.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4836934&req=5

FI1500062-2: (A) Anteroposterior and lateral radiograph demonstrating anterior placement of the kidney-shaped interbody cage. (B) Anteroposterior and lateral radiograph demonstrating placement of the straight interbody cage.
Mentions: The procedure for the c-TLIF group began by placing autogenous local bone in the disk space behind the ALL. The curved spacer was then placed into the disk space. The spacer was worked around the periphery of the disk space, moving toward its anterior aspect. Final impaction was performed until the spacer abutted the cancellous bone graft and ALL, with its long axis oriented in a medial-lateral direction (Fig. 2A). The TLIF group, likewise, received autogenous graft impacted behind the ALL. The graft used was a straight, rectangular cage with a bullet nose that aids in entering the disk space. The graft was placed in an oblique fashion toward the midline, as anteriorly as possible within the disk space. No cases received two implants at the same level. Both groups received pedicle screw fixation for stabilization of the fusion construct and posterolateral bone grafting (Fig. 2B). Compression along the pedicle screw/rod construct was performed in all cases to improve the sagittal alignment for both groups.

Bottom Line: Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed.Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001).Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Marshall University, Huntington, West Virginia, United States.

ABSTRACT
Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. Results One hundred one patients were included in the study. Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001). Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes.

No MeSH data available.