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Stand-alone LLIF Lateral Cage Migration: A Case Report.

Wendy S Towers¹, Khalid H Kurtom¹

¹Neurosurgery, University of Maryland Shore Regional Health.

|December 2, 2015

Summary

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A rare case of stand-alone cage migration after lateral lumbar interbody fusion (LLIF) is presented. This complication, though rare, can be managed conservatively, especially when asymptomatic.

Area of Science:

Neurosurgery
Orthopedic Surgery
Spinal Fusion Techniques

Background:

Lateral lumbar interbody fusion (LLIF) is increasingly utilized for degenerative lumbar conditions.
Complications associated with LLIF are generally infrequent.
This case highlights a rare complication: stand-alone cage migration.

Observation:

A 77-year-old female with L2-3 radiculopathy underwent LLIF for foraminal stenosis, degenerative disc disease, levoscoliosis, and spondylolisthesis.
A polyetheretherketone (PEEK) cage packed with demineralized bone matrix (DBM) was used for fusion.
Postoperative imaging initially showed successful graft placement and spinal alignment.

Findings:

Three months postoperatively, asymptomatic ipsilateral cage migration at L2-3 was observed on X-ray.

Keywords:

cage migration lateral lumbar fusion minimally invasive spine surgery

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Evidence of arthrodesis (bone fusion) was present in the disc space.

The patient was managed conservatively without surgical intervention.

Implications:

This case suggests that asymptomatic cage migration following LLIF may be managed conservatively.
For patients with significant coronal deformity or scoliosis, considering supplemental fixation like a lateral plate or intradiscal plating may prevent migration.
Further research into preventative strategies for LLIF cage migration in complex spinal deformities is warranted.