PT  - JOURNAL ARTICLE
AU  - Bakare, Adewale A.
AU  - Fessler, David R.
AU  - Wewel, Joshua T.
AU  - Fontes, Ricardo B. V.
AU  - Fessler, Richard G.
AU  - O'Toole, John E.
TI  - Changes in Segmental and Lumbar Lordosis After Lateral Lumbar Interbody Fusion With Different Lordotic Cage Angulations
AID  - 10.14444/8066
DP  - 2021 Jun 01
TA  - International Journal of Spine Surgery
PG  - 440--448
VI  - 15
IP  - 3
4099  - https://www.ijssurgery.com/content/15/3/440.short
4100  - https://www.ijssurgery.com/content/15/3/440.full
SO  - Int J Spine Surg2021 Jun 01; 15
AB  - Background: Lateral lumbar interbody fusion (LLIF) affords a wide operative corridor to allow for a large interbody cage implantation for segmental reconstruction. There is a paucity of data describing segmental lordosis (SL) achieved with lordotic implants of varying angles. Here we compare changes in SL and lumbar lordosis (LL) after implantation of 6°, 10°, and 12° cages.Methods: We retrospectively reviewed LLIF cases over a 5.5-year period. We derived SL and LL using the standard cobb angle measurement from a standing lateral radiograph. We analyzed mean changes in SL and LL over time using the linear mixed effect model to estimate these longitudinal changes.Results: The most frequently treated level was L3–4, followed by L4–5. Significant increases in mean SL were found at each follow-up time point for all the cohorts. In an intercohort comparison, the mean changes in SL at immediate postoperative and last follow-up were significantly greater in the 10° cohort than 6° ([7.4° versus 3.1°, P = .004], [6.1° versus 2.3°, P = .025] respectively). The 12° cohort had higher mean change in SL at last follow-up than the 6° cohort (5.9° versus 2.3°, P = .022). There was no difference in mean change in SL between the 10° and 12° cohorts. No difference in overall mean LL over time was found. In terms of mean change in LL, no difference was observed except at immediate and 6-month postoperative in the 10° cohort ([9.6°, P = .001], [8.5, P = .003] respectively). By comparing mean change in LL, no difference existed except between the 10° and 6° immediately after surgery (9.6° versus 0.2°, P = .006).Conclusions: LLIF cages significantly improve SL at the index level. However, this increase in SL is greater for 10° and 12° cages than the standard 6° cage. Use of 10° cages also resulted in overall improved LL than 6° cages.Level of Evidence: 3.Clinical Relevance: Lateral lumbar interbody fusion.