Journal of Spine

A Novel Lateral Titanium Expandable Interbody Spacer with Integrated Plate Restores Anterior and Posterior Disc Height and Intervertebral Lordosis

Abstract

Robert L Brady, Jessica R Riggleman, Amber L Edsall and Charles G Ledonio

Background: Expandable integrated titanium interbody spacers have been introduced in recent years for use in minimally invasive lateral lumbar interbody fusion (MIS LLIF) procedures. These devices offer in situ expansion that enables them to conform to intervertebral anatomy with potentially less endplate disruption and greater indirect decompression. This study describes the radiographic outcomes in patients who underwent MIS LLIF using titanium expandable interbody spacers with an integrated plate.

Method: This is a single-surgeon, retrospective, Institutional Review Board-exempt chart review conducted from June 2015 to December 2017 on consecutive patients diagnosed with spondylolisthesis who underwent MIS LLIF at 1–2 contiguous level(s) using a lateral integrated titanium expandable interbody spacer. Radiographic outcomes were collected and compared from preoperative to postoperative at 2 and 6 weeks, 3, 6, 9, and 12 month follow-ups. Statistical results were significant when P<0.05.

Results: Seventeen consecutive patients were evaluated with an average age of 69.2 ± 7.9 years (range: 51–82 years), and 58.8% were female. Mean anterior disc height significantly improved from baseline by 68.3% (7.7 ± 4.5 mm), 58.4% (6.9 ± 5.0 mm), 59.4% (7.0 ± 4.6 mm), 56.4% (6.1 ± 5.0 mm), 52.5% (5.7 ± 4.8 mm), and 51.5% (4.2 ± 4.0 mm) at 2 and 6 weeks, 3, 6, 9, and 12, months, respectively (P<0.001). Mean posterior disc height significantly improved from baseline by 78.0% (4.9 ± 2.9 mm), 67.8% (4.3 ± 2.9 mm), 66.1% (4.3 ± 2.9 mm), 69.5% (4.3 ± 3.0 mm), 57.6% (3.8 ± 2.7 mm), and 61.0% (3.2 ± 2.5 mm) at 2 and 6 weeks, 3, 6, 9, and 12, months, respectively (P<0.001). Segmental and lumbar lordosis remained consistent at all postoperative time points (P>0.05).

Conclusion: This study showed significant positive radiographic outcomes for patients who underwent MIS LLIF using novel integrated titanium expandable interbody spacers, based on significant post-operative changes in intervertebral lordosis and anterior and posterior disc height observed through 12-month follow-up.