Balancing Benefits and Risks of the Use of Cage in Lumbar Spondylolisthesis Surgery: A Meta-Analysis

Lumbar spondylolisthesis is a prevalent spinal disorder for which the primary treatment approach involves surgical intervention, including reduction, decompression, internal fixation, and bone graft fusion. This systematic review evaluated and compared the clinical efficacy of posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) procedures using a cage, as opposed to posterolateral fusion (PLF) procedures without a cage, for the treatment of lumbar spondylolisthesis. The use of a cage has been shown to improve fusion rate and reduce functional disability. Patients who underwent inter-lumbar fusion with a cage experienced lower scores for postoperative lower back pain, with no significant difference in leg pain scores. Additionally, the use of a cage led to a decrease in postoperative complications, although there was no significant difference in operation time. The incorporation of a cage during lumbar spondylolisthesis surgery has been found to augment the efficacy of pedicle screw fixation through the simultaneous management of nerve decompression and pedicle screw fixation, resulting in significant enhancements in patient prognosis. Key Words: Spondylolisthesis, Pain, Fusion, Cage, Meta-analysis.