Abstract
Abstract INTRODUCTION Use of large interbody spacers in minimally invasive lateral lumbar interbody fusion (MIS LLIF) commonly offers favorable clinical and radiographic results. Expandable interbody spacers with adjustable lordosis offer in Situ expansion that may optimize endplate contact and maximize/maintain sagittal correction until fusion occurs. This study compares clinical and radiographic outcomes between patients treated with static and expandable interbody spacers with adjustable lordosis for MIS LLIF. METHODS This is a multi-surgeon, retrospective, institutional review board-exempt chart review of consecutive patients who underwent MIS LLIF at 1 to 2 contiguous level (s) using either PEEK static (27 patients) or titanium expandable spacer with adjustable lordosis (24 patients). Mean differences of radiographic/clinical functional outcomes were collected/compared from preoperative to 24-mo postoperative follow-up. Statistical results were significant if P < .05. RESULTS Mean improvement of visual analog scale (VAS) back pain scores from preoperative to 6, 12, 24 mo was significantly higher in expandable group compared to static group (P < .05). Oswestry Disability Index (ODI) score mean improvement from preoperative to 3, 6, 12, 24 mo was significantly higher in expandable group compared to static group (P < .05). Expandable group had significantly greater mean improvement in segmental lordosis from preoperative to 6 wk, 3, 6, and 12 mo (P < .05). For disc height, mean improvement from preoperative to 24 mo was more significant in static group compared to expandable group (P < .05). Neuroforaminal height mean improvement from preoperative to 6 wk, 3 and 6 mo was significantly greater in expandable group compared to static group (P < .05). Subsidence was 0% in expandable group and 18.5% in static group. CONCLUSION This study showed significant positive clinical and radiographic outcomes for patients who underwent MIS LLIF using titanium expandable interbody spacers with adjustable lordosis based on significant changes in VAS back pain scores, ODI scores, and radiographic parameters at 24-mo follow-up.
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