Radiographic Analysis of Endplate Coverage of a 3-Dimensional-Expandable Transforaminal Lumbar Interbody Fusion (TLIF) Implant Compared to Static TLIF and Anterior Lumbar Interbody Fusion Implants

Sep 30, 2026

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Radiographic outcomes were evaluated for endplate coverage after interbody fusion using static TLIF, 3-dimensional (3D)-expandable TLIF, and ALIF implants. The study retrospectively reviewed patients treated between 2014 and 2022 and quantified postoperative CT measurements of implant and endplate dimensions. Coverage ratio was defined from implant area relative to superior and inferior endplate areas at the operative level. Results showed higher coverage for 3D-expandable TLIF versus static TLIF and closer coverage to ALIF, with subgroup parity at L3–4 and L4–5 and ALIF superiority at L5–S1.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

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Objective

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Neurospine 2025;22(4):891-901. [https://doi.org/10.14245/ns.2551166.583](https://doi.org/10.14245/ns.2551166.583) Neurospine pISSN 2586-6583 eISSN 2586-6591 Original Article Corresponding Author Richard G. Fessler [https://orcid.org/0000-0002-7432-0950](https://orcid.org/0000-0002-7432-0950) Department of Neurological Surgery, Rush University Medical Center, 1620 W Harrison St, Chicago, IL 60612, USA Email: [rfessler@rush.edu](rfessler@rush.edu) Received: August 6, 2025 Revised: October 23, 2025 Accepted: October 25, 2025 See the commentary “Radiographic Analysis of Endplate Coverage of a 3-Dimensional-Expandable Transforaminal Lumbar Interbody Fusion (TLIF) Implant Compared to Static TLIFand Anterior Lumbar Interbody Fusion Implants” via [https://doi.org/10.14245/](https://doi.org/10.14245/)[ ](https://doi.org/10.14245/)ns.2551806.903. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecom](https://creativecom)[mons.org/licenses/by-nc/4.0/](mons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2025 by the Korean Spinal Neurosurgery Society Radiographic Analysis of Endplate Coverage of a 3-DimensionalExpandable Transforaminal Lumbar Interbody Fusion (TLIF) Implant Compared to Static TLIF and Anterior Lumbar Interbody Fusion Implants Jacob Mazza, Manhal Siddiqi, John Paul G. Kolcun, Dominick Richards, Richard G. Fessler Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA Objective: Transforaminal lumbar interbody fusion (TLIF) has become a mainstay technique for interbody fusion, allowing for large contact area between implant and endplate, and providing increased stability and greater area for fusion . The development of 3-dimensional (3D)-expandable implants that provide multidimensional (3D) expansion has shown to provide better height restoration and clinical outcomes when compared to static implants. Comparison of the endplate coverage between 3D-expandable and static TLIF implants has yet to be studied. This study compares endplate coverage achieved with static TLIF, 3D-expandable TLIF, and anterior lumbar interbody fusion (ALIF) implants. Methods: A retrospective review of patients undergoing interbody fusion with either static TLIF, 3D-expandable TLIF, or ALIF between the years 2014 and 2022 was conducted. Postoperative computed tomography (CT) imaging was used to measure endplate and implant dimensions . 3D-expandable TLIF interbody device areas were calculated using diameter measurements on postoperative CT. The coverage ratio was defined as the ratio of twice the area ofthe implant and the sum of the superior and inferior endplate areas at the operative level. Results: A total of 53 patients per cohort were included. The average endplate coverage ratios for static TLIF, 3D-expandable TLIF, and ALIF implants were 0.19 ± 0.04, 0.35 ± 0.06, and 0.46 ± 0.13, respectively. Subgroup analysis showed comparable coverage of 3D-expandable TLIF to ALIF implants at L3–4 and L4–5, while ALIF remained superior at L5–S1 . Conclusion: 3D-expandable TLIF interbody devices provide greater endplate coverage when compared to static TLIF devices and approach comparable coverage to ALIF implants. Keywords: Spine surgery, Lumbar interbody fusion, Minimally invasive surgery, Expandable implant, Radiographic review INTRODUCTION Interbody fusion remains a cornerstone treatment for degenerative spine conditions, providing mechanical stability, disc height restoration, neural decompression, and bony arthrodesis.1-3 Among various approaches, transforaminal lumbar interbody fusion (TLIF) balances surgical access with biomechanical stability while attempting to maximize vertebral endplate con- [www.e-neurospine.org](www.e-neurospine.org) 891 tact.4,5 Static (nonex

FAQs

What was the study objective regarding endplate coverage?

To compare endplate coverage achieved with static TLIF, 3D-expandable TLIF, and ALIF implants using radiographic measurements.

How were endplate coverage and implant dimensions measured?

Postoperative CT imaging was used to measure endplate and implant dimensions, and coverage ratio was calculated from implant area relative to superior and inferior endplate areas.

What were the main coverage results across implant types?

Average endplate coverage ratios were 0.19±0.04 for static TLIF, 0.35±0.06 for 3D-expandable TLIF, and 0.46±0.13 for ALIF.

Did 3D-expandable TLIF match ALIF in specific lumbar levels?

Subgroup analysis showed comparable coverage between 3D-expandable TLIF and ALIF at L3–4 and L4–5, while ALIF remained superior at L5–S1.

Sep 30, 2026

Uploaded by Stanley