title: Clinical and radiological outcomes of a new cage for direct lateral lumbar interbody fusion.
abstract: OBJECTIVE
  In Korea, direct lateral interbody fusion (DLIF) was started since 2011, using standard cage (6° lordotic angle, 18mm width). Recently, a new wider cage with higher lordotic angle (12°, 22mm) was introduced. The aim of our study is to compare the clinical and radiologic outcomes of the two cage types.
  
  
  METHODS
  We selected patients underwent DLIF, 125 cases used standard cages (standard group) and 38 cases used new cages (wide group). We followed them up for more than 6 months, and their radiological and clinical outcomes were analyzed retrospectively. For radiologic outcomes, lumbar lordotic angle (LLA), segmental lordoic angle (SLA), disc angle (DA), foraminal height change (FH), subsidence and intraoperative endplate destruction (iED) were checked. Clinical outcomes were compared using visual analog scale (VAS) score, Oswestry disability index (ODI) score and complications.
  
  
  RESULTS
  LLA and SLA showed no significant changes postoperatively in both groups. DA showed significant increase after surgery in the wide group (p<0.05), but not in the standard group. Subsidence was significantly lower in the wide group (p<0.05). There was no difference in clinical outcomes between the two groups. Additional posterior decompression was done more frequently in the wide group. Postoperative change of foraminal height was significantly lower in the wide group (p<0.05). The iED was observed more frequently in the wide group (p<0.05) especially at the anterior edge of cage.
  
  
  CONCLUSIONS
  The new type of cage seems to result in more DA and less subsidence. But indirect foraminal decompression seems to be less effective than standard cage. Intraoperative endplate destruction occurs more frequently due to a steeper lordotic angle of the new cage.
authors.affiliation: Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Shin Jae
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Young Baeg
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Orthopedic and Trauma, Quang Nam Central General Hospital, Quang Nam, Vietnam.
authors.forename: Vo Tan
authors.initials: VT
authors.lastname: Hung
keywords: Cage; DLIF; Outcome; Type