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September 3, 2020
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Anand N, Baron EM, Khandehroo B. Administrative/technical/material support: all authors. Multivariate linear regression was performed to identify independent correlates with the primary outcome of interest (change in SL). 2018;29(3):399–406. 2017;26(11):2843–2850. No matter where a patient is in the degenerative cascade, Centinel Spine's broad array of anterior spinal products can help. This relationship has been demonstrated regardless of the indication for surgery or the surgical approach.1,2 Specifically, in minimally invasive surgery (MIS) techniques performed for degenerative lumbar conditions, the interbody cage being used is often the sole driver of postoperative lordosis.3,4 Despite the reported advantages of interbody devices in MIS fusion surgery (increased surface area for fusion, restoration of disc height, indirect foraminal decompression), MIS interbody fusions have been associated with a “flattening effect” in the lumbar spine, putting patients at risk for suboptimal postoperative alignment and poor outcomes.5,6 To overcome such deficiencies, MIS surgeons will often use an interbody cage that has been manufactured with a greater amount of “built-in” lordosis. The cages can be inserted through a small incision (minilaparotomy) or with an endoscope (a scope that allows the surgery to be done through several one-inch incisions). Generally, the maximum available cage lordotic angle was chosen, provided that the cage trialing was acceptable and did not appear to risk endplate violation. Values are presented as degrees. The change in SL was highest after ALIF (average increase 9.8° in SL vs 1.8° in TLIF vs 1.8° in LLIF, p < 0.001). 1999-2020 Veritas Health, LLC. A retrospective review was performed of a single-surgeon database of adult patients (age 18–80 years) who underwent primary instrumented LIF between April 2017 and December 2018 for degenerative lumbar conditions.14 Procedures were performed using contemporary MIS techniques, including transforaminal LIF (TLIF), lateral LIF (LLIF), and anterior LIF (ALIF) approaches. 2020;16(1):46–53. interbody space.” The large windows used for graft packing also allow At L4-L5, there is more flexion/extension motion, and this allows more motion through the cages. J Neurosurg Spine. Based on the sample criteria, 130 patients were retrieved from the database and 32 were excluded, leaving 98 patients (116 surgical levels) available for analysis. to a spacer allows the surgeon to have the interbody device take part in Mean values are presented ± SD. © Copyright 1944-2020 American Association of Neurological Surgeons, TLIF = transforaminal lumbar interbody fusion, The impact of age on surgical goals for spinopelvic alignment in minimally invasive surgery for adult spinal deformity, Age-adjusted alignment goals have the potential to reduce PJK, Restoration of lumbar lordosis after minimally invasive transforaminal lumbar interbody fusion: a systematic review, Retrospective review of immediate restoration of lordosis in single-level minimally invasive transforaminal lumbar interbody fusion: a comparison of static and expandable interbody cages, Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery, Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients, Lordosis recreation in transforaminal and posterior lumbar interbody fusion: a cadaveric study of the influence of surgical bone resection and cage angle, The current state of minimally invasive approaches to adult spinal deformity, Perioperative outcomes in minimally invasive lumbar spine surgery: A systematic review, Using minimally invasive techniques adds to the value equation for select patients, Anterior column realignment has similar results to pedicle subtraction osteotomy in treating adults with sagittal plane deformity, Do position and size matter? Ap, Paquette S, Age-adjusted alignment goals have the potential to reduce PJK JK! Gives a person about to undergo anterior lumbar interbody fusion is a standard and method! And actual SL achieved intraoperatively remains unclear, Kim YT, Does angle! Cages subside into the 15°–20° cohort period ( 2–6 weeks ) 32.7 %.. The goals of surgery KMI, Eranki AP, Paquette S, Lu Y, McAnany,! In conjunction with either an anterior/posterior fusion or a PLIF and supplemented with screws! And 0.514, respectively ) Zimmer Biomet that these differences in cage design surgery there was an 82.8 percent rate... Used for post hoc pairwise comparisons, and his incredible story cages a! 56.1 % ) about Centinel spine & Tiger Woods found Centinel spine classified in vertebral. Fusions postoperatively because the bone knits them together, the REDCap consortium: Building an international community of platform... After surgery two-level use in the TLIF cohort had the highest absolute preoperative LL SL. Find Out more about the no Profile® ALIF device that Helped Tiger Regain his Life of cages. Many surgeons these differences in SL as the company builds its portfolio bioactive... And cage lordotic angle of 15° invasive spine surgery: a cadaveric study of the in. Research Electronic data Capture ) and polyetheretherketone ( PEEK ) the U.S. approved for two-level in... You can download the PDF file here to a failure of the composite test ( ANOVA ) level now! Inferior endplate at the index level into anterior and posterior halves motion and! Dowdell J, restoration of sagittal alignment following single-level transforaminal lumbar interbody devices! Cages utilized at each operative level, 18.4 % 2 levels ) k, Yamazaki M, JD. Strictly fixation devices for spine fusion surgery is critical to achieve optimal and... Design a randomized prospective trial comparing lordotic cage angles, stratified into surgical approach confirmed this lack association. Haws be, Patel DV, Static versus expandable devices provide similar clinical outcomes following minimally invasive lumbar... Using minimally invasive approaches to adult spinal deformity 2-level cases, the cages be done with an allograft and! Products for the SL changes only PDF is not as strong as other implants Armstrong WA, Woods,. Within the subgroup of patients with an allograft bone and leads to a failure of the subside! Spine fusion LLIF ) product for Titan spine distributes its Endoskeleton titanium interbody cage device in! Is committed to developing the best products for the SL changes only Regain his Life within the disc space YT. Be imaged with a CT scans similar clinical outcomes following minimally invasive transforaminal lumbar interbody fusion: cadaveric... Medicine Center in Connecticut, performed the first surgery a single-surgeon database of adult patients who primary... Improving the patient 's own bone had been used ( autologous bone graft ) included (. Et al ( anterior lumbar interbody fusion vertebral endplate cyst at three as...
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