The biomechanical goals of lumbar interbody fusion are to restore alignment, restore intervertebral and foraminal height, and promote fusion by providing immediate stability (ability to limit segmental motions under physiologic load). Interbody cages can aid in achieving these goals, especially bone graft resorption/disc height loss. Biomechanical and clinical data suggest that PLIF stand-alone cages may not provide adequate stability and supplemental stabilization may be needed for a more predictable biomechanical environment conducive to fusion. However,besides the PLIF approach to place cages, a number of other approaches (e.g., far lateral - LIF,transforaminal - TLIF and anterior – ALIF) are used. The hypothesis for the present study is that some of these approaches preserve the structures that impart stability to the segment and thus stand-alone cage placed using those approaches may provide sufficient stability without additional posterior instrumentation (360 constructs). Additionally, the size, footprint, and end plate support for the cages differ and may play a role in the surgical success. Such a comprehensive study is somewhat lacking in the literature. The outcome may enable industry with the design and development of an appropriate cage which will be very effective the imparting the stability to the decompressed segment.
Principal Investigator: Vijay Goel, PhD
Co-Principal Investigator: Anand Agarwal, MD
Trainee: Sushil Sudershan