cages. Park et al. reported 34 patients with foraminal stenosis treated
with bilateral stand-alone expandable cages and 91% of the patients
were satisfied [8]. The fusion rate was 88% and 30% of the patients
were noted with subsidence, of which the majority had no symptoms.
Park et al. also reported on long-term outcome of 211 patients
with degenerative spine diseases treated with bilateral stand-alone
expandable cages [9]. Five years after surgery, the overall clinical success
rate dropped to 74.4%. The fusion rate was 85.2% and the disc height
was continuously reduced in time with poor sagital alignment. They
concluded that, in particular in patients with multilevel surgery and
high-risk pseudarthrosis such as diabetes, stand-alone intercorporal
cages should not be used. Lequin et al. reported on bilateral standalone
TM cages in patients with recurrent disc herniation [6]. Only
46% of the patients reported good outcome although 85% had some
benefit from the operation. However, 69% of the patients had a history
of 2 or more surgeries on the index level, which could explain the
modest results. Recently, van der Kelft and van Goethem published a
randomised trial on 80 patients treated with bilateral TM cages, with or
without additional pedicle screw fixation [7]. There was no difference
in clinical and radiological outcome between both groups and TM
cage were shown to provide solid constructs, irrespective of additional
pedicle screw fixation.
cages. Park et al. reported 34 patients with foraminal stenosis treatedwith bilateral stand-alone expandable cages and 91% of the patientswere satisfied [8]. The fusion rate was 88% and 30% of the patientswere noted with subsidence, of which the majority had no symptoms.Park et al. also reported on long-term outcome of 211 patientswith degenerative spine diseases treated with bilateral stand-aloneexpandable cages [9]. Five years after surgery, the overall clinical successrate dropped to 74.4%. The fusion rate was 85.2% and the disc heightwas continuously reduced in time with poor sagital alignment. Theyconcluded that, in particular in patients with multilevel surgery andhigh-risk pseudarthrosis such as diabetes, stand-alone intercorporalcages should not be used. Lequin et al. reported on bilateral standaloneTM cages in patients with recurrent disc herniation [6]. Only46% of the patients reported good outcome although 85% had somebenefit from the operation. However, 69% of the patients had a historyof 2 or more surgeries on the index level, which could explain themodest results. Recently, van der Kelft and van Goethem published arandomised trial on 80 patients treated with bilateral TM cages, with orwithout additional pedicle screw fixation [7]. There was no differencein clinical and radiological outcome between both groups and TMcage were shown to provide solid constructs, irrespective of additionalpedicle screw fixation.
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