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Bidirectional Expandable Technology for Transforaminal or Posterior Lumbar Interbody Fusion: A Retrospective Analysis of Safety and Performance
Journal article   Open access   Peer reviewed

Bidirectional Expandable Technology for Transforaminal or Posterior Lumbar Interbody Fusion: A Retrospective Analysis of Safety and Performance

Domagoj Coric, Raphael R. Roybal, Mark Grubb, Vincent Rossi, Alex K. Yu, Isaac R. Swink, Jason Long, Boyle C. Cheng and Jason A. Inzana
International journal of spine surgery, v 14(s3), pp S22-S30
01 Dec 2020
DOI: https://doi.org/10.14444/7123
PMID: 33122186
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.14444/7123View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Background: Expandable devices for transforaminal or posterior lumbar interbody fusion (TLIF and PLIF, respectively) may enable greater restoration of disc height, foraminal height, and stability within the interbody space than static spacers. Medial-lateral expansion may also increase stability and resistance to subsidence. This study evaluates the clinical and radiographic outcomes from early experience with a bidirectional expandable device. Methods: This was a retrospective analysis of a continuous series of patients across 3 sites who had previously undergone TLIF or PLIF surgery with a bidirectional expandable interbody fusion device (FlareHawk, Integrity Implants, Inc) at 1 or 2 contiguous levels between L2 and S1. Outcomes included the Oswestry Disability Index (ODI), a visual analog scale (VAS) for back pain or leg pain, radiographic fusion by 1 year of follow-up, subsidence, device migration, and adverse events (AE). Results: There were 58 eligible patients with radiographs for 1-year fusion assessments and 45 patients with ODI, VAS back pain, or VAS leg pain data at baseline and a mean follow-up of 4.5 months. The ODI, VAS back pain, and VAS leg pain scores improved significantly from baseline to final follow-up, with mean improvements of 14.6 +/- 19.1, 3.4 +/- 2.6, and 3.9 +/- 3.4 points (P<.001 for each), respectively. In addition, 58% of patients achieved clinically significant improvements in ODI, 76% in VAS back pain, and 71% in VAS leg pain. By 1 year, 96.6% of patients and 97.4% of levels were considered fused. There were zero cases of device subsidence and 1 case of device migration (1.7%). There were zero device-related AEs, 1 intraoperative dural tear, and 3 subsequent surgical interventions. Conclusions: The fusion rate, improvements in patient-reported outcomes, and the AEs observed are consistent with those of other devices. The bidirectional expansion mechanism may provide other important clinical value, but further studies will be required to elucidate the unique advantages. Level of Evidence: 4.

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9 citations in Web of Science
9 citations in Scopus

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Web of Science research areas
Surgery
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