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Advances in Orthopedics
Volume 2011, Article ID 176497, 5 pages
Clinical Study

Anterior Lumbar Interbody Implants: Importance of the Interdevice Distance

1The Virginia Spine Institute, Reston, VA 20190, USA
2The Spinal Research Foundation, 1831 Wiehle Avenue, Suite 200, Reston, VA 20190, USA

Received 7 October 2010; Accepted 28 December 2010

Academic Editor: John P. Kostuik

Copyright © 2011 Brian R. Subach et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Object. The implantation of interbody fusion cages allows for the restoration of disc height and the enlargement of the neuroforaminal space. The purpose of this study was to compare the extent of subsidence occurring after conventional cage placement compared to a novel wider cage placement technique. Methods. This study is a retrospective evaluation of radiographs of patients who underwent stand-alone single level anterior lumbar interbody fusion with lordotic titanium cages and rhBMP-2. Fifty-three patients were evaluated: 39 patients had wide cage placement (6 mm interdevice distance) and 14 had narrow cage placement (2 mm interdevice distance). Anterior and posterior intervertebral disc space heights were measured post-operatively and at follow-up imaging. Results. The decrease in anterior intervertebral disc space height was 2.05 mm versus 3.92 mm ( 𝑃 < . 0 0 5 ) and 1.08 mm versus 3.06 mm in posterior disc space height for the wide cage placement and the narrow cage placement respectively. The proportion of patients with subsidence greater than 2 mm was 41.0% in the wide cage patients and 85.7% for the narrow cage patients ( 𝑃 < . 0 0 5 ). Conclusions. The wider cage placement significantly reduced the amount of subsidence while allowing for a greater exposed surface area for interbody fusion.