{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:43Z","timestamp":1787025763958,"version":"build-2736575974"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Transforaminal lumbar interbody fusion (TLIF) is commonly used for lumbar fusion, such as for foraminal decompression, stabilization, and improving segmental lordosis. Although many options exist, surgical success is contingent on matching design strengths with surgical goals. The goal in the present study was to investigate the effects of an expandable interbody spacer and 2 traditional static spacer designs in terms of stability, compressive stiffness, foraminal height, and segmental lordosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Standard nondestructive flexibility tests (7.5 N\u22c5m) were performed on 8 cadaveric lumbar specimens (L3\u2013S1) to assess intervertebral stability of 3 types of TLIF spacers at L4\u20135 with bilateral posterior screw-rod (PSR) fixation. Stability was determined as range of motion (ROM) in flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Compressive stiffness was determined with axial compressive loading (300 N). Foraminal height, disc height, and segmental lordosis were evaluated using radiographic analysis after controlled PSR compression (170 N). Four conditions were tested in random order: 1) intact, 2) expandable interbody cage with PSR fixation (EC+PSR), 3) static ovoid cage with PSR fixation (SOC+PSR), and 4) static rectangular cage with PSR fixation (SRC+PSR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>All constructs demonstrated greater stability than the intact condition (p &lt; 0.001). No significant differences existed among constructs in ROM (FE, AR, and LB) or compressive stiffness (p \u2265 0.66). The EC+PSR demonstrated significantly greater foraminal height at L4\u20135 than SRC+PSR (21.1 \u00b1 2.6 mm vs 18.6 \u00b1 1.7 mm, p = 0.009). EC+PSR demonstrated higher anterior disc height than SOC+PSR (14.9 \u00b1 1.9 mm vs 13.6 \u00b1 2.2 mm, p = 0.04) and higher posterior disc height than the intact condition (9.4 \u00b1 1.5 mm vs 7.1 \u00b1 1.0 mm, p = 0.002), SOC+PSR (6.5 \u00b1 1.8 mm, p &lt; 0.001), and SRC+PSR (7.2 \u00b1 1.2 mm, p &lt; 0.001). There were no significant differences in segmental lordosis among SOC+PSR (10.1\u00b0 \u00b1 2.2\u00b0), EC+PSR (8.1\u00b0 \u00b1 0.5\u00b0), and SRC+PSR (11.1\u00b0 \u00b1 3.0\u00b0) (p \u2265 0.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>An expandable interbody spacer provided stability, stiffness, and segmental lordosis comparable to those of traditional nonexpandable spacers of different shapes, with increased foraminal height and greater disc height. These results may help inform decisions about which interbody implants will best achieve surgical goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2019.1.spine181008","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T18:25:01Z","timestamp":1555093501000},"page":"383-389","source":"Crossref","is-referenced-by-count":7,"title":["Tailoring selection of transforaminal interbody spacers based on biomechanical characteristics and surgical goals: evaluation of an expandable spacer"],"prefix":"10.3171","volume":"32","author":[{"given":"Jakub","family":"Godzik","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer N.","family":"Lehrman","sequence":"additional","affiliation":[{"name":"Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna G. U. S.","family":"Newcomb","sequence":"additional","affiliation":[{"name":"Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Kumar","family":"Menon","sequence":"additional","affiliation":[{"name":"Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C.","family":"Whiting","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E79","DOI":"10.1097\/BRS.0b013e3182226ba6","article-title":"Biomechanical evaluation of an expandable cage in single-segment posterior lumbar interbody fusion","volume":"37","author":"Bhatia NN","year":"2012","unstructured":"Bhatia NN, Lee KH, Bui CN, Luna M, Wahba GM, Lee TQ: Biomechanical evaluation of an expandable cage in single-segment posterior lumbar interbody fusion. Spine (Phila Pa 1976) 37:E79\u2013E85, 201210.1097\/BRS.0b013e3182226ba6"},{"key":"b2","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/0002-9610(53)90421-8","article-title":"The treatment of ruptured lumbar intervertebral discs; criteria for spinal fusion","volume":"86","author":"Cloward RB","year":"1953","unstructured":"Cloward RB: The treatment of ruptured lumbar intervertebral discs; criteria for spinal fusion. Am J Surg 86:145\u2013151, 195310.1016\/0002-9610(53)90421-813065582"},{"key":"b3","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2097","DOI":"10.1097\/00007632-199510000-00005","article-title":"An apparatus for applying pure nonconstraining moments to spine segments in vitro","volume":"20","author":"Crawford NR","year":"1995","unstructured":"Crawford NR, Brantley AG, Dickman CA, Koeneman EJ: An apparatus for applying pure nonconstraining moments to spine segments in vitro. Spine (Phila Pa 1976) 20:2097\u20132100, 199510.1097\/00007632-199510000-00005"},{"key":"b4","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1097\/00007632-199703010-00020","article-title":"Construction of local vertebral coordinate systems using a digitizing probe. Technical note","volume":"22","author":"Crawford NR","year":"1997","unstructured":"Crawford NR, Dickman CA: Construction of local vertebral coordinate systems using a digitizing probe. Technical note. Spine (Phila Pa 1976) 22:559\u2013563, 199710.1097\/00007632-199703010-00020"},{"key":"b5","series-title":"Clin Biomech (Bristol, Avon)","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/S0268-0033(98)00080-1","article-title":"A new technique for determining 3-D joint angles: the tilt\/twist method","volume":"14","author":"Crawford NR","year":"1999","unstructured":"Crawford NR, Yamaguchi GT, Dickman CA: A new technique for determining 3-D joint angles: the tilt\/twist method. Clin Biomech (Bristol, Avon) 14:153\u2013165, 199910.1016\/S0268-0033(98)00080-1"},{"key":"b6","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1097\/01.brs.0000179086.30449.96","article-title":"The impact of positive sagittal balance in adult spinal deformity","volume":"30","author":"Glassman SD","year":"2005","unstructured":"Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F: The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976) 30:2024\u20132029, 200510.1097\/01.brs.0000179086.30449.96"},{"key":"b7","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1097\/01.BRS.0000083167.78853.D5","article-title":"Influence of cage geometry on sagittal alignment in instrumented posterior lumbar interbody fusion","volume":"28","author":"G\u00f6dde S","year":"2003","unstructured":"G\u00f6dde S, Fritsch E, Dienst M, Kohn D: Influence of cage geometry on sagittal alignment in instrumented posterior lumbar interbody fusion. Spine (Phila Pa 1976) 28:1693\u20131699, 200310.1097\/01.BRS.0000083167.78853.D5"},{"issue":"2","key":"b8","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.3171\/2017.5.FOCUS17197","article-title":"Minimally invasive transforaminal lumbar interbody fusion with expandable versus static interbody devices: radiographic assessment of sagittal segmental and pelvic parameters","volume":"43","author":"Hawasli AH","year":"2017","unstructured":"Hawasli AH, Khalifeh JM, Chatrath A, Yarbrough CK, Ray WZ: Minimally invasive transforaminal lumbar interbody fusion with expandable versus static interbody devices: radiographic assessment of sagittal segmental and pelvic parameters. Neurosurg Focus 43(2):E10, 20172876003210.3171\/2017.5.FOCUS17197"},{"key":"b9","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.wneu.2016.02.075","article-title":"Minimally invasive transforaminal lumbar interbody fusion using expandable technology: a clinical and radiographic analysis of 50 patients","volume":"90","author":"Kim CW","year":"2016","unstructured":"Kim CW, Doerr TM, Luna IY, Joshua G, Shen SR, Fu X, : Minimally invasive transforaminal lumbar interbody fusion using expandable technology: a clinical and radiographic analysis of 50 patients. World Neurosurg 90:228\u2013235, 20162692170010.1016\/j.wneu.2016.02.075"},{"key":"b10","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1487","DOI":"10.1097\/BRS.0b013e3181f41b60","article-title":"Lordosis restoration after Smith-Petersen osteotomies and interbody strut placement: a radiographic study in cadavers","volume":"35","author":"Lee MJ","year":"2010","unstructured":"Lee MJ, Wiater B, Bransford RJ, Bellabarba C, Chapman JR: Lordosis restoration after Smith-Petersen osteotomies and interbody strut placement: a radiographic study in cadavers. Spine (Phila Pa 1976) 35:E1487\u2013E1491, 201010.1097\/BRS.0b013e3181f41b60"},{"key":"b11","series-title":"Clin Neurosurg","first-page":"514","article-title":"Posterior lumbar interbody fusion: indications, techniques, and results","volume":"47","author":"McLaughlin MR","year":"2000","unstructured":"McLaughlin MR, Haid RW Jr, Rodts GE Jr, Subach BR: Posterior lumbar interbody fusion: indications, techniques, and results. Clin Neurosurg 47:514\u2013527, 200011197722"},{"key":"b12","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1097\/00007632-198810000-00013","article-title":"Biomechanical evaluation of spinal fixation devices: I. A conceptual framework","volume":"13","author":"Panjabi MM","year":"1988","unstructured":"Panjabi MM: Biomechanical evaluation of spinal fixation devices: I. A conceptual framework. Spine (Phila Pa 1976) 13:1129\u20131134, 198810.1097\/00007632-198810000-00013"},{"key":"b13","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.spinee.2014.10.010","article-title":"Additional sagittal correction can be obtained when using an expandable titanium interbody device in lumbar Smith-Peterson osteotomies: a biomechanical study","volume":"15","author":"Qandah NA","year":"2015","unstructured":"Qandah NA, Klocke NF, Synkowski JJ, Chinthakunta SR, Hussain MM, Salloum KG, : Additional sagittal correction can be obtained when using an expandable titanium interbody device in lumbar Smith-Peterson osteotomies: a biomechanical study. Spine J 15:506\u2013513, 201510.1016\/j.spinee.2014.10.01025315134"},{"key":"b14","series-title":"Clin Spine Surg","first-page":"47","article-title":"Should expandable TLIF cages be used routinely to increase lordosis?","volume":"30","author":"Rymarczuk GN","year":"2017","unstructured":"Rymarczuk GN, Harrop JS, Hilis A, H\u00e4rtl R: Should expandable TLIF cages be used routinely to increase lordosis? Clin Spine Surg 30:47\u201349, 201728207614"},{"key":"b15","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1007\/s00586-008-0739-1","article-title":"Comparative study of PILF and TLIF treatment in adult degenerative spondylolisthesis","volume":"17","author":"Yan DL","year":"2008","unstructured":"Yan DL, Pei FX, Li J, Soo CL: Comparative study of PILF and TLIF treatment in adult degenerative spondylolisthesis. Eur Spine J 17:1311\u20131316, 200810.1007\/s00586-008-0739-118685873"},{"key":"b16","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1093\/neuros\/nyw177","article-title":"Expandable vs static cages in transforaminal lumbar interbody fusion: radiographic comparison of segmental and lumbar sagittal angles","volume":"81","author":"Yee TJ","year":"2017","unstructured":"Yee TJ, Joseph JR, Terman SW, Park P: Expandable vs static cages in transforaminal lumbar interbody fusion: radiographic comparison of segmental and lumbar sagittal angles. Neurosurgery 81:69\u201374, 20172836854210.1093\/neuros\/nyw177"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/32\/3\/article-p383.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/32\/3\/article-p383.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/32\/3\/article-p383.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T18:56:11Z","timestamp":1681584971000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/32\/3\/article-p383.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":16,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2019.1.spine181008","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3]]}}}