Volume 28, Issue 2
DOI: 10.53555/03276716.2019.1107
Comparative Radiological and Clinical Outcomes of Expandable vs. Static Implants in Posterior Lumbar Interbody Fusion
Abstract
Aims: Interbody fusion implants are one of the surgical tools frequently used to achieve and sustain disc height, intraoperative stability, and spinal lordosis in the lumbar region. Expandable posterior lumbar interbody fusion (PLIF) implants provide intraoperative adjustability and may enhance the spinal biomechanical aspects compared to static implants. Our study aims to evaluate the radiographic, clinical, and safety characteristics of expandable and static PLIF implants in patients with degenerative lumbar disease.
Methods: This study was a randomized clinical controlled clinical trial on 126 patients (18 to 75 years old) who had undergone PLIF surgery between December 2017 and December 2018. Patients were divided into expandable (n=63) and static (n=63) implant groups. Radiographic measurements were analyzed, including disc height, foraminal height, and lumbar lordosis at preoperative, postoperative 3, 6, and 12 months follow-ups. Patient-related outcomes were assessed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS).
Results: Expandable implants resulted in significantly greater improvements in anterior disc height ( 3.3 mm, p < 0.001), posterior disc height ( 2.7 mm, p < 0.001), and foraminal height ( 4.2 mm, p < 0.001). ODI and VAS scores also improved significantly. The complication rate was lower in the expandable group (15.9%) compared to the static group (22.2%), with a relative risk of 0.72 (95% CI: 0.55–0.95).
Conclusion: Expandable PLIF implants are associated with significant radiographic benefits, better functional improvement, and fewer complications than static implants. Long-term follow-up is needed to assess the durability of these advantages and evaluate potential late-onset complications such as adjacent segment disease.
Keywords
posterior lumbar interbody fusion; spine surgery; interbody fusion implants