The Effectiveness of Tritanium Cages in Preventing Osteolytic Vertebral Endplate Cysts After Lumbar Interbody Fusion

Abstract

ObjectiveLumbar interbody fusion (LIF) is a common surgical procedure, but postoperative complications, such as osteolytic vertebral endplate cysts, can adversely affect patient outcomes. This study aims to investigate whether Tritanium cages (Stryker, Mahwah, NJ) are effective in preventing osteolytic vertebral endplate cysts after LIF. MethodsClinical data from 8 years (2013–2020) of LIF procedures at our hospital were analyzed. Computed tomography was employed to assess the formation of osteolytic vertebral endplate cysts 6 months post-surgery. Clinical factors potentially associated with cyst formation were compared among 3 different interbody spacer materials: Tritanium, titanium, and Polyetheretherketone (PEEK). ResultsLIF was performed for 169 patients at 205 spinal levels, employing Tritanium cages in 56 levels (48 patients), titanium in 103 levels (86 patients), and PEEK in 46 levels (35 patients). At 6 months after LIF, 27.3% of patients exhibited worsening of osteolytic vertebral endplate cysts. Multivariate logistic regression analysis revealed that Tritanium cages (odds ratio [OR]: 3.86; 95% CIs: 1.46–10.21) and titanium (OR: 2.55; 95% CIs: 1.13–5.75), and posterior LIF (OR: 5.74; 95% CI: 2.24–14.74) were associated with a reduced risk of postoperative osteolytic vertebral endplate cysts. ConclusionTritanium cages have demonstrated promise in preventing postoperative osteolytic vertebral endplate cysts, suggesting their potential as a stable and effective choice in LIF procedures. These findings have significant implications for improving patient outcomes and warrant further investigation to optimize surgical techniques and materials.