A recent retrospective cohort study by Austin Nguyen MD et al. from Rush University Medical Center, Chicago, IL, has shed light on the impact of cage angle in anterior lumbar interbody fusion (ALIF) surgery. The findings indicate that while cage angle does not significantly affect most radiographic outcomes, such as global lordosis and disc height, it plays a crucial role in the occurrence of cage subsidence.
The study reveals a significant association between increased cage angles beyond 15° lordosis and the risk of subsidence, urging a cautious approach in the use of these so-called hyperlordotic cages in stand-alone ALIF procedures. These insights emphasize the importance of carefully selecting cage angles to optimize patient outcomes and minimize complications.
Axis Spine Technologies’ modular ‘wedge within a wedge’ ALIF cage offers a promising solution to these challenges. This innovative cage can be inserted in a low-profile state, reducing the risk of damage to vertebral endplates and subsequent subsidence. Once in place, the cage height and lordosis can be precisely dialed in in-situ, providing a patient customized solution.
The ability to dial in the optimal cage height and angle post-insertion could revolutionize ALIF surgery, ensuring better alignment and stability while mitigating the risks highlighted by recent research. This approach aligns with the study’s recommendations for judicious use of cage angles, ultimately enhancing patient care and surgical outcomes.
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