• Akira Yamagishi, Masayoshi Ishii, Hironobu Sakaura, Ryoji Yamasaki, Atsunori Ohnishi, Hiroyuki Tsukazaki, Tetsuo Ohwada, and Wataru Ando.
• Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan. Electronic address: bullto13@icloud.com.
• World Neurosurg. 2024 Mar 1; 183: e201e209e201-e209.

ObjectivePosterior lumbar interbody fusion (PLIF) with cortical bone trajectory (CBT) screw fixation (CBT-PLIF) shows potential for reducing adjacent segmental disease. Previously, our investigations revealed a relatively lower fusion rate with the use of carbon fiber-reinforced polyetheretherketone (CP) cages in CBT-PLIF compared with traditional pedicle screw fixation (PS-PLIF) using CP cages. This study aims to evaluate whether the implementation of titanium-coated polyetheretherketone (TP) cages can enhance fusion outcomes in CBT-PLIF.MethodsA retrospective analysis was conducted on 68 consecutive patients who underwent CBT-PLIF with TP cages (TP group) and 89 patients who underwent CBT-PLIF with CP cages (CP group). Fusion status was assessed using computed tomography at 1 year postoperatively and dynamic plain radiographs at 2 years postoperatively.ResultsNo statistically significant differences in fusion rates were observed at 1 and 2 years postoperatively between the TP group (86.8% and 89.7%, respectively) and the CP group (77.5% and 88.8%, respectively). Notably, the CP group exhibited a significant improvement in fusion rate from 1 to 2 years postoperatively (P = 0.002), while no significant improvement was observed in the TP group.ConclusionsExamination of temporal changes in fusion rates reveals that only the TP group achieved a peak fusion rate 1 year postoperatively. This implies that TP cages may enhance the fusion process even after CBT-PLIF. Nevertheless, the definitive efficacy of TP cages for CBT-PLIF remains uncertain in the context of overall fusion rates.Copyright © 2023 Elsevier Inc. All rights reserved.

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