PMID- 35178326
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220219
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 1
DP  - 2022 Jan
TI  - Radiographic and Patient-Reported Outcomes of Lordotic Versus Non-lordotic Static 
      Interbody Devices in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A 
      Longitudinal Comparative Cohort Study.
PG  - e21273
LID - 10.7759/cureus.21273 [doi]
LID - e21273
AB  - Introduction Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) 
      is increasingly used to treat lumbar degenerative pathology. Its effect on 
      sagittal parameters remains controversial. Static and expandable lordotic 
      interbody devices (cages) were developed to improve segmental and overall lumbar 
      lordosis. This study aimed to compare the radiographic and patient-reported 
      outcomes (PROs) between static lordotic and non-lordotic titanium cages in 
      patients undergoing 1-2 level MI-TLIF for degenerative conditions.  Methods We 
      reviewed consecutive eligible patients who underwent 1-2 level MI-TLIF 
      (7/2017-11/2019) at a single institution by multiple surgeons. Standing X-rays 
      and PROs were collected at preoperative, 1-month, and 6-month postoperative 
      intervals. Using univariate analyses, we compared the two cohorts regarding 
      confounders, radiographic parameters, and proportions of patients reaching 
      minimal clinically important difference (MCID) for PROs. Results 
      One-hundred-twenty-five patients were reviewed. Forty-seven had lordotic and 
      seventy-eight non-lordotic cages. The lordotic cohort was significantly younger 
      than the non-lordotic (55.9 years vs. 60.7 years, p= 0.042). The baseline 
      radiographic parameters were not significantly different between cohorts. At the 
      preoperative-6-month interval, the lordotic cohort had significant improvement in 
      lumbar lordosis versus non-lordotic cohort (2.95 degrees  +/- 7.2 degrees  vs. -0.3 degrees  +/- 7.1 degrees , 
      p=0.024). Both cohorts showed improvement in segmental lordosis, anterior and 
      posterior interspace height, and low subsidence grade with no significant 
      difference between cohorts at all intervals. Overall, 69.1-83.8% of patients 
      achieved MCID in all PROs with no significant difference between cohorts. 
      Conclusions The use of a static lordotic titanium cage in 1-2 level MI-TLIF did 
      not result in significantly different radiographic improvements or PROs compared 
      with a non-lordotic cage.
CI  - Copyright (c) 2022, Lawless et al.
FAU - Lawless, Michael H
AU  - Lawless MH
AD  - Division of Neurosurgery, Ascension Providence Hospital, Michigan State 
      University, College of Human Medicine, Southfield, USA.
FAU - Claus, Chad F
AU  - Claus CF
AD  - Division of Neurosurgery, Ascension Providence Hospital, Michigan State 
      University, College of Human Medicine, Southfield, USA.
FAU - Tong, Doris
AU  - Tong D
AD  - Division of Neurosurgery, Ascension Providence Hospital, Michigan State 
      University, College of Human Medicine, Southfield, USA.
FAU - Jordan, Noah
AU  - Jordan N
AD  - Surgery, University of Kentucky College of Medicine, Lexington, USA.
FAU - Dosanjh, Amarpal
AU  - Dosanjh A
AD  - College of Osteopathic Medicine, Michigan State University, East Lansing, USA.
FAU - Hanson, Connor T
AU  - Hanson CT
AD  - Division of Neurosurgery, Ascension Providence Hospital, Michigan State 
      University, College of Human Medicine, Southfield, USA.
FAU - Carr, Daniel A
AU  - Carr DA
AD  - Division of Neurosurgery, Ascension Providence Hospital, Michigan State 
      University, College of Human Medicine, Southfield, USA.
FAU - Houseman, Clifford M
AU  - Houseman CM
AD  - Division of Neurosurgery, Ascension Providence Hospital, Michigan State 
      University, College of Human Medicine, Southfield, USA.
LA  - eng
PT  - Journal Article
DEP - 20220115
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8843108
OTO - NOTNLM
OT  - lordotic cage
OT  - lordotic interbody device
OT  - lumbar osteoarthritis
OT  - minimally invasive
OT  - tlif
OT  - transforaminal lumbar interbody fusion
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/02/19 06:00
MHDA- 2022/02/19 06:01
PMCR- 2022/01/15
CRDT- 2022/02/18 05:50
PHST- 2022/01/03 00:00 [received]
PHST- 2022/01/15 00:00 [accepted]
PHST- 2022/02/18 05:50 [entrez]
PHST- 2022/02/19 06:00 [pubmed]
PHST- 2022/02/19 06:01 [medline]
PHST- 2022/01/15 00:00 [pmc-release]
AID - 10.7759/cureus.21273 [doi]
PST - epublish
SO  - Cureus. 2022 Jan 15;14(1):e21273. doi: 10.7759/cureus.21273. eCollection 2022 
      Jan.