Lumbar Lordosis Correction With Interbody Hyperlordotic Cages: Initial Experience, Learning Curve, Technical Aspects, and Complication Incidence

Background: Analysis of the initial experience on learning curve, technical differences and perioperative or early postoperative complications using lumbar hyperlordotic anterior and lateral interbody cages for the correction of lumbar lordosis as compared with the usage of regular lordotic cages.

Methods: Initial 21 consecutive patients were treated with 13 hyperlordotic anterior lumbar interbody fusion (ALIF) cages and 8 hyperlordotic extreme lateral interbody fusion (XLIF) cages. The mean patient age was 64 years, and the mean lumbar hypolordosis was 23°.

Results: No significant procedure-related technical differences were found between the hyperlordotic and nonhyperlordotic ALIF cages. Slightly significant procedure-related technical differences were found between hyperlordotic and nonhyperlordotic XLIF cages. The complication type and occurrence were comparable.

Conclusions: Sagittal balance correction of lumbar lordosis using hyperlordotic ALIF and XLIF cages is a relatively safe surgical procedure with a short learning curve for those surgeons already familiar with anterior and lateral retroperitoneal procedures.