Radiological finding of intervertebral stability of transforaminal lumbar interbody fusion with dual boomerang cages and posterior lumbar interbody fusion with two rectangular cages

Abstract

Introduction: When compared to transforaminal lumbar interbody fusion (TLIF) with a single boomerang cage (DB technique) enhances intervertebral stability. TLIF for lumbar degenerative disease can achieve clinical results comparable to PLIF; however, there are no reports of the superiority of TLIF over PLIF in terms of radiological results, and corrective loss in TLIF is an issue.

Objective: To clarify the intervertebral stability of DB and posterior lumbar interbody fusion (PLIF), including cage subsidence and intervertebral bone fusion.

Methods: The patients underwent DB (group D) or PLIF (group P) for lumbar degenerative disease. The primary outcome was the incidence of cage subsidence (>2 mm on computed tomography) 1 year postoperatively, and the secondary outcome was the incidence of intervertebral non-union. Logistic regression was used to calculate the risk ratio for cage subsidence.

Results: Cage subsidence occurred more frequently in the P group, 15 (17%) cases in the D group, and 26 (41%) cases in the P group (P=0.002); the adjusted risk ratio for cage subsidence in the D group was 0.56 (95% CI: 0.33-0.97), halving the incidence of cage subsidence in the D group compared with the P group. The percentage of non-union between the vertebral bodies was 33 (38%) cases in group D and 29 (45%) in group (P=0.4).

Conclusions: The DB technique may improve intervertebral stability with less cage subsidence than PLIF.