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Oblique lateral interbody fusion using angle-adjustable cage.

Nam-Su Chung1, Han-Dong Lee1, Jong-Min Jeon1

  • 1Department of Orthopaedic Surgery, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, Geyounggi-do, 16499, South Korea.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|February 4, 2025
PubMed
Summary
This summary is machine-generated.

Angle-adjustable cages improve cage rotation and positioning during oblique lateral interbody fusion (OLIF) at L4-L5, especially for patients with a high iliac crest. This technique offers better radiological outcomes in spinal fusion surgery.

Keywords:
Angle-adjustable cageCage obliquityIliac crest heightOblique lateral interbody fusionRadiological outcome

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Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Degenerative lumbar disease

Background:

  • Orthogonal cage rotation is crucial for oblique lateral interbody fusion (OLIF).
  • The iliac crest can limit cage placement during L4-L5 OLIF.
  • Angle-adjustable cages aim to overcome iliac crest limitations, but their efficacy requires further study.

Purpose of the Study:

  • To compare radiological outcomes between conventional and angle-adjustable cages in L4-L5 OLIF.
  • To evaluate the impact of angle-adjustable cages on cage obliquity and anterior positioning.
  • To determine the utility of angle-adjustable cages in patients with high iliac crests.

Main Methods:

  • A retrospective study of 90 patients undergoing L4-L5 OLIF for degenerative lumbar disease.
  • Group I (41 patients) received conventional cages; Group II (49 patients) received angle-adjustable cages.
  • Radiological outcomes including cage obliquity, position, foraminal height, fusion rate, and subsidence were compared.

Main Results:

  • No significant difference in mean iliac crest height between groups.
  • Greater cage obliquity in the conventional cage group (12.1°) compared to the angle-adjustable group (8.3°).
  • More anterior cage positioning in the conventional cage group (6.3 mm) versus the angle-adjustable group (4.7 mm).

Conclusions:

  • Angle-adjustable cages facilitate superior orthogonal cage rotation and anterior cage positioning in L4-L5 OLIF.
  • The angle-adjustable cage system is particularly beneficial for L4-L5 OLIF in patients with a high iliac crest.
  • This technology enhances surgical options for achieving optimal cage placement in challenging anatomies.