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Lateral-PLIF for Lumbar Spinal Arthrodesis: A Detailed Step-By-Step Surgical Technique
Published on: January 23, 2026
Circumferential arthrodesis using PEEK cages at the lumbar spine
Marc-Antoine Rousseau1, Jean-Yves Lazennec, Gérard Saillant
1Department of Orthopaedic Surgery, La Pitié-Salpétrière Hospital, University of Paris VI, France. m_a_rousseau@hotmail.com
Journal of Spinal Disorders & Techniques
|June 1, 2007
Summary
Anterior polyetheretherketone (PEEK) cages in lumbar spine surgery show good fusion rates and clinical outcomes. However, initial lordosis correction may not be maintained long-term, particularly with higher cages or rigid posterior fixation.
Area of Science:
- Spine Surgery
- Orthopedic Biomaterials
- Spinal Fusion
Background:
- Traditional lumbar interbody cages utilize titanium or carbon fiber-PEEK.
- Pure polyetheretherketone (PEEK) cages offer a lower elasticity modulus, prompting investigation into their use.
- Degenerative lumbar spine disorders often require surgical intervention with interbody fusion.
Purpose of the Study:
- To evaluate clinical outcomes and local lordosis changes in patients undergoing circumferential lumbar fixation with anterior PEEK cages.
- To identify factors influencing the maintenance of lordosis after PEEK cage implantation.
Main Methods:
- A retrospective review of 57 consecutive patients with degenerative lumbar disorders treated with anterior PEEK cages and circumferential fixation.
- Assessment of clinical status, fusion rates, and radiologic changes in local lordosis at the arthrodesis level.
- Multivariate analysis to determine predictors of lordosis decrease at long-term follow-up (average 5.7 years).
Main Results:
- Excellent or good clinical outcomes were reported in 49 patients, with definite fusion in 56.
- While some patients experienced immediate lordosis increase, 13 cases showed a significant decrease (average 5.6 degrees) at follow-up.
- Multivariate analysis revealed that loss of lordosis was significantly associated with postoperative lordosis increase, higher cage height, rigid posterior instrumentation, older age, and lower spinal levels.
Conclusions:
- Anterior PEEK cages in lumbar circumferential arthrodesis achieve favorable clinical results and fusion rates.
- Lordosis correction achieved at surgery may not be sustained over time.
- Factors such as cage height, posterior instrumentation rigidity, patient age, and spinal level influence the long-term maintenance of lumbar lordosis.
