Posterior Insertion of a Lateral Lumbar Interbody Fusion Cage for the Treatment of Osteoporotic Vertebral Fracture with Kyphotic Deformity: A Case Report

INTRODUCTION: Stable fixation with a wide-foot-plate expandable cage and lateral lumbar interbody fusion (LLIF) cage has been reported as the ideal treatment for vertebral pseudarthrosis or deformity after an osteoporotic vertebral fracture. (OVF). The procedure requires anterior surgery, which may be associated with unique complications. Therefore, we performed a novel procedure consisting of posterior vertebral column resection (PVCR) using a lateral lumbar interbody fusion LLIF cage. CASE PRESENTATION: In 2020, we prospectively studied three patients (one male and two female patients; mean age, 75.1 years) who underwent posterior insertion of a lateral lumbar interbody fusion LLIF cage for kyphotic deformity due to osteoporotic vertebral fractures. OVFs. The affected levels were L1, T12, and T11 in patients one, two, and three, respectively. The cage trajectory was confirmed by simulating the procedure using PowerPoint® software. Radiological outcomes were assessed using the angle of local kyphosis pre-preoperatively and postoperatively, and the clinical outcomes and neurological complications were reviewed. We inserted the cage smoothly and optimally in all three patients without sacrificing the nerve root, consistent with our pre-operative simulations. The mean operation time was 405 min (range, 368–433 min), and the mean blood loss was 845 mL (range, 800–865 mL). The mean local kyphotic angle was 46.3° preoperatively and 16.3° two2 weeks postoperatively. The pre-operative low back pain disappeared in all the patients. Post-operative neurological complications occurred in two of the patients, but did not interfere with walking rehabilitation. CONCLUSION: The present study is the first to demonstrate that posterior insertion of a lateral lumbar interbody fusionLLIF cage is feasible in patients undergoing posterior vertebral column resection. PVCR.