title: Can cantilever transforaminal lumbar interbody fusion (C-TLIF) maintain segmental lordosis for degenerative spondylolisthesis on a long-term basis?
abstract: OBJECTIVE
  To determine if cantilever transforaminal lumbar interbody fusion (C-TLIF) using the crescent-shaped titanium interbody spacer (IBS) favors acquisition of segmental and lumbar lordosis even for degenerative spondylolisthesis (DS) on a long-term basis.
  
  
  METHODS
  We analyzed 23 consecutive patients who underwent C-TLIF with pedicle screw instrumentations fixed with compression for a single-level DS. Measurements on the lateral radiographs taken preoperatively, 2 weeks postoperatively and at final follow-up included disc angle (DA), segmental angle (SA), lumbar lordosis (LL), disc height (%DH) and slip rate (%slip).
  
  
  RESULTS
  There was a good functional recovery with 100 % fusion rate at the mean follow-up of 62 months. Segmental lordosis (DA and SA) and %DH initially increased, but subsequently decreased with the subsidence of the interbody spacer, resulting in a significant increase (p = 0.046) only in SA from 13.2° ± 5.5° preoperatively to 14.7° ± 6.4° at the final follow-up. Changes of LL and %slip were more consistent without correction loss finally showing an increase of LL by 3.6° (p = 0.005) and a slip reduction by 6.7 % (p < 0.001).
  
  
  CONCLUSIONS
  Despite the inherent limitation of placing the IBS against the anterior endplate of the upper vertebra in the presence of DS, the C-TLIF helped significantly restore segmental as well as lumbar lordosis on a long-term basis, which would be of benefit in preventing hypolordosis-induced back pain and the adjacent level disc disease.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Medical School, Kohasu Oko-cho, Nankoku, Kochi, 783-8505, Japan, kazugonkochi@gmail.com.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Kida
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Tadokoro
authors.forename: Masashi
authors.initials: M
authors.lastname: Kumon
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ikeuchi
authors.forename: Tateo
authors.initials: T
authors.lastname: Kawazoe
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008141:Lordosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D019736:Prostheses and Implants; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium