Exploring the differences in radiologic and clinical outcomes of transforaminal lumbar interbody fusion with single- and bi-planar expandable cages: a systematic review and meta-analysis

Stavros Matsoukas, Mert Karabacak, Konstantinos Margetis

Research output: Contribution to journalReview articlepeer-review

Abstract

Transforaminal lumbar interbody fusion (TLIF) is a universal surgical technique used to achieve lumbar fusion. Traditionally static cages have been used to restore the disc space after discectomy. However, newer technological advancements have brought up uniplanar expandable cages (UECs) and more recently bi-planar expandable cages (BECs), the latter with the hope of reducing the events of intra- or postoperative subsidence compared to UECs. However, since BECs are relatively new, there has been no comparison to UECs. In this PRISMA-compliant systematic review, we sought to identify all Medline and Embase reports that used UECs and/or BECs for TLIF or posterior lumbar interbody fusion. Primary outcomes included subsidence and fusion rates. Secondary outcomes included VAS back pain score, VAS leg pain score, ODI, and other complications. A meta-analysis of proportions was the main method used to evaluate the extracted data. Bias was assessed using the ROBINS-I tool. A total of 15 studies were pooled in the analysis, 3 of which described BECs. There were no studies directly comparing the UECs to BECs. A statistically significant difference in fusion rates was found between UECs and BECs (p = 0.04). Due to lack of direct comparative literature, definitive conclusions cannot be made about differences between UECs and BECs. The analysis showed a statistically higher fusion rate for BECs versus UECs, but this should be interpreted cautiously. No other statistically significant differences were found. As more direct comparative studies emerge, future meta-analyses may clarify potential differences between these cage types.

Original languageEnglish
Article number36
JournalNeurosurgical Review
Volume47
Issue number1
DOIs
StatePublished - Dec 2024

Keywords

  • Static cages
  • Transforaminal lumbar interbody fusion
  • Uniplanar expandable cages

Fingerprint

Dive into the research topics of 'Exploring the differences in radiologic and clinical outcomes of transforaminal lumbar interbody fusion with single- and bi-planar expandable cages: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this