TLIF Cage Introduction, Sizes, Uses and Advantages.

TLIF Cage

TLIF Cage Introduction

The lumbar area of the spine may experience severe discomfort and functional limitations. The TLIF cage is one of the successful remedies that have been created as a result of improvements in surgical methods.

After the injured intervertebral disc has been removed, the TLIF cage is put into the disc space. The cage is intended to restore and maintain normal disc height, as well as to provide stability and fusion between the vertebrae.

TLIF Cage Sizes

The TLIF cage is a small, hollow device made of various materials such as titanium or polyetheretherketone (PEEK). TLIF cages come in a variety of shapes and sizes to meet the demands of the patient.

Titanium Mesh Cage are available in various diameters and lengths.
Diameters: 8MM, 10mm, 12mm, 14mm AND 16mm.
Lengths: 24mm, 28mm and 32mm

TLIF Cage Uses

During a TLIF procedure, the surgeon enters the spine by a back incision. They cut a small gap between adjacent vertebrae by removing a part of the lamina (the bony arch of the vertebra). This enables access to the intervertebral disc space.

After the injured intervertebral disc has been removed, the TLIF Cage is put into the disc space. The cage is intended to restore and maintain normal disc height while also providing stability and vertebral fusion.

The TLIF Cage functions as a spacer, maintaining disc height and restoring vertebral alignment. It creates a stable environment for bone graft material to be implanted, encouraging vertebral fusion. The bone graft material grows and fuses with the neighbouring spinal bone during the fusion process, resulting in a solid, stable fusion mass.

TLIF Cage Advantage

Restoration of Disc Height: The TLIF cage aids in the restoration of the compressed disc’s height, easing strain on surrounding nerves and reducing discomfort.

Enhanced Fusion: The cage increases the chances of successful vertebral fusion by providing support and encouraging bone development.

Reduced Risk of Implant Migration: TLIF cages have elements such as screws or spikes that secure the cage in place, limiting the danger of migration and assuring perfect alignment.

The PLIF and TLIF techniques

Background: Posterior fusion procedures (posterior lumbar interbody fusion, PLIF; transforaminal lumbar interbody fusion, TLIF) are long-established surgical techniques for lumbar interbody fusion. They differ from anterior lumbar interbody fusion (ALIF) and extreme lateral interbody fusion (XLIF) procedures by approach and associated complications.

Objectives: The posterior fusion procedures PLIF and TLIF are presented and compared with other fusion methods, including advantages and disadvantages. Furthermore, the surgical technique and their complications are described. Based on the current literature, it is discussed which surgical techniques can be used in various cases.

Results: PLIF and TLIF procedures reduced back and leg pain, restored the sagittal profile of the lumbar spine, and achieved good fusion rates and long-term stability. Advantages of the TLIF procedure include shorter operative times, less blood loss, less intraoperative risk of injury to neural structures, and shorter convalescence. Compared with the interposition of a cage in the ALIF technique, a further step with the risk of vascular injury is eliminated.

Conclusions: The PLIF and TLIF procedures are almost equivalent posterior fusion procedures with high fusion rates, good long-term clinical outcomes, and low risk of complications. The TLIF procedure is slightly advantageous: lower nerve irritation rates, shorter operative times, and less extensive operation. Thus, the TLIF procedure is available for cases with single-sided pathologies and the PLIF procedure is available for bilateral compressions.

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TLIF Cage Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include:

Any active or suspected latent infection or marked local inflammation in or about the affected area.
Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
Material sensitivity, documented or suspected.
Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to
failure of the device itself.
Patients having inadequate tissue coverage over the operative site.
Implant utilization that would interfere with anatomical structures or physiological performance.
Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
Other medical or surgical conditions which would preclude the potential benefit of surgery.
All associated diseases which could endanger the function and success of the TLIF Cage .

Warnings and Precautionary for TLIF Cage

Before using TLIF Cage, the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Cage is made from medical grade materials and are designed, constructed and produced with utmost care. These quality Cage assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of Cage can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of implants.

Factors which could impair the success of the operation:

Allergies to implanted materials.
Localized bone tumours.
Osteoporosis or osteomalacia.
System disease and metabolic disturbances.
Alcohol and drug abuse.
Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
Patients who are mentally unable to understand and comply with the doctor’s instructions.
Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

Loosening of the Cage, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
Early and late infection.
Further bone fracture resulting from unusual stress or weakened bone substance.
Temporary or chronic neural damage resulting from pressure or hematomata.
Wound hematomas and delayed wound healing.
Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
Heterotopic ossification.
Pain and discomfort due to presence of the TLIF Cage.
Mechanical failure of the implant, including bending, loosening or breakage.
Migration of implant resulting in injury.

Preoperative Planning for TLIF Cage

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete size of TLIF Cage must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of implants. It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

TLIF Cage Precautions

Confirm functionality of instruments and check for wear during reprocessing. Replace worn or damaged instruments prior to use.
It is recommended to use the instruments identified for this Cage.
Handle devices with care and dispose worn bone cutting instruments in a sharps container.
Always irrigate and apply suction for removal of debris potentially generated during implantation or removal.

TLIF Cage Warnings

TLIF Cage can break during use (when subjected to excessive forces). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the individual patient, the broken part should be removed. Be aware that implants are not as strong as native bone. Implants subjected to substantial loads may fail.
Instruments, screws and cut plates may have sharp edges or moving joints that may pinch or tear user’s glove or skin.
Take care to remove all fragments that are not fixated during the surgery.
While the surgeon must make the final decision on implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Cage removal should be followed by adequate post-operative management to avoid refracture.

TLIF Cage General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the TLIF Cage, reoperation.

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TLIF Cage Introduction, Sizes, Uses and Advantages.

TLIF Cage Introduction

TLIF Cage Sizes

TLIF Cage Uses

TLIF Cage Advantage

The PLIF and TLIF techniques

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