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An analysis of fusion cage migration in unilateral and bilateral fixation with transforaminal lumbar interbody fusion

Authors
  • Duncan, Jan William1
  • Bailey, Richard Anthony2
  • 1 University of Southern California, Keck School of Medicine, Department of Orthopaedic Surgery, 711 West College Street, Suite 625, Los Angeles, CA, 90012, USA , Los Angeles (United States)
  • 2 California Spine, 711 West College Street, Suite 625, Los Angeles, CA, 90012, USA , Los Angeles (United States)
Type
Published Article
Journal
European Spine Journal
Publisher
Springer-Verlag
Publication Date
Aug 10, 2012
Volume
22
Issue
2
Pages
439–445
Identifiers
DOI: 10.1007/s00586-012-2458-x
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeTo investigate if instrumentation (unilateral vs. bilateral fixation) has an effect on the rate of fusion cage migration.MethodsThis clinical study of transforaminal lumbar interbody fusion involved a prospective group of 116 patients who were randomly assigned to either unilateral (n = 57) or bilateral (n = 59) fixation. Fourteen were lost to follow-up (11 from the unilateral group and 3 from the bilateral group).ResultsThe unilateral fixation group consisted of 20 male and 26 female patients. In the unilateral group, the mean age was 53.5 years (range, 18–77), and the preoperative diagnosis consisted of degenerative disc disease, with or without herniated disc (n = 44), and degenerative spondylolisthesis with spinal stenosis (n = 2). The bilateral fixation group consisted of 20 male and 36 female patients. In the bilateral group, the mean age was 55.7 years (range, 26–82), and the preoperative diagnosis consisted of degenerative disc disease, with or without herniated disc (n = 40), and degenerative spondylolisthesis with spinal stenosis (n = 16). A total of 17 cases of cage migration were found; of these, 11 were from the unilateral group and 6 from the bilateral group, resulting in rates of cage migration of 23 and 11 % (p = 0.03), respectively. In regard to migration cases, 5 were male and 12 were female. Ages ranged from 27 to 79 years (mean age, 55 years).ConclusionWe conclude that unilateral fixation is not stable enough to prevent fusion cage migration in some patients who undergo TLIF.

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