Biplanar Expandable Cages for Transforaminal Lumbar Interbody Fusion Are Safe and Achieve Good 1-Year Clinical and Radiological Outcomes in an Asian Population

Outer polyetheretherketone shell, seen from the top and side.

Inner titanium shim, seen from the top and side.

Outer polyetheretherketone (PEEK) shell and inner titanium shim loaded in-line onto inserter instrument, seen from the side (direction of advancement of inner titanium shim into outer PEEK shell as demonstrated by the black arrow).

Intraoperative fluoroscopic confirmation of satisfactory cage position before expansion, anterior-posterior and lateral view.

Biplanar expansion in medial-lateral direction and cranial-caudal direction achieved with advancement of inner titanium shim into outer polyetheretherketone shell, seen from the top and side.

Biplanar expansion of the cage was achieved via advancing the inner titanium shim into the outer polyetheretherketone shell as visualized on lateral intraoperative fluoroscopy.

Final position of expanded cage with pedicle screws and rods inserted, anterior-posterior and lateral view.