Analysis of single cage position in transforaminal lumbar interbody fusion through digital images
- 166 Downloads
The purpose of this study was to investigate the position of single cage inserted using oblique-oriented technique in transforaminal lumbar interbody fusion (TLIF) on digital images of computed tomography (CT).
From January to August 2015, 44 consecutive patients with degenerative lumbar disease who underwent TLIF in the L4/5 level were retrospectively studied in our department. The single cage was inserted using the oblique-oriented technique; as the main purpose of the study, its position was analyzed using post-operative digital computed tomography images.
All cages used in the study had the same length of 36 mm, which were inserted into the discs with a 46.04 ± 3.09-mm horizontal diameter and 34.25 ± 3.59-mm longitudinal diameter. The horizontal and longitudinal diameter of the treated disk established the coordinate. The horizontal and longitudinal coordinate values of the centre of the cage were 0.08 ± 4.12 and 1.20 ± 2.76 mm, respectively. The horizontal distance of the cage centre from the midpoint of the disc negatively correlated with that of the entry point from the midpoint of the disc in the coronal plane.
A longer single cage can be placed into the L4/5 level disk by inserting it using the oblique-oriented technique. Its center can reach the midpoint of the treated disk in the coronal plane and the anterior position of the disk in the sagittal plane. The entry point of the cage is the further away from the midpoint of the disk; the cage is the more apt to reach the center of the disk in the coronal plane.
KeywordsDigital images TLIF Single cage Position
This study is supported by National Natural Science Foundation of China “Biomechanical study of lumbar degeneration patterns in different spine sagittal curves” (81572168), China.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 8.Fogel GR, Toohey JS, Neidre A, Brantigan JW (2007) Is one cage enough in posterior lumbar interbody fusion: a comparison of unilateral single cage interbody fusion to bilateral cages. J Spinal Disord Tech 20:60 https://doi.org/10.1097/01.bsd.0000211251.59953.a4 CrossRefPubMedGoogle Scholar
- 9.Kai Z, Wei S, Zhao C, Hua L, Wei D, Xie Y, Sun X, Jie Z (2014) Unilateral versus bilateral instrumented transforaminal lumbar interbody fusion in two-level degenerative lumbar disorders: a prospective randomised study. Int Orthop 38:111–116 https://doi.org/10.1007/s00264-013-2026-y CrossRefGoogle Scholar
- 10.Castellvi AD, Thampi SK, Cook DJ, Yeager MS, Yuan Y, Zou Q, Whiting DM, Oh MY, Prostko ER, Cheng BC (2015) Effect of TLIF cage placement on in vivo kinematics. Int J Spine Surg 9(38) https://doi.org/10.14444/2038
- 12.Kim SB, Jeon TS, Heo YM, Lee WS, Yi JW (2009) Radiographic results of single level transforaminal lumbar interbody fusion in degenerative lumbar spine disease: focusing on changes of segmental lordosis in fusion segment. Clin Orthop Surg 1:207–213. https://doi.org/10.4055/cios.2009.1.4.207 CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Fukuta S, Miyamoto K, Hosoe H, Shimizu K (2011) Kidney-type intervertebral spacers should be located anteriorly in cantilever transforaminal lumbar interbody fusion: analyses of risk factors for spacer subsidence for a minimum of 2 years. J Spinal Disord Tech 24:189. https://doi.org/10.1097/BSD.0b013e3181e9f249 CrossRefPubMedGoogle Scholar