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Extrusion of Expandable Stacked Interbody Device for Lumbar Fusion: Case Report of a Complication

Kim, Paul D., MD*; Baron, Eli M., MD; Levesque, Michel, MD, FRCSC, FACS

doi: 10.1097/BRS.0b013e318257f14d
Case Report

Study Design. A case report.

Objective. We report on the device failure of a polyetherether-ketone expandable cage device with posterior migration of one of its components.

Summary of Background Data. Posterior migration of transforaminal lumbar interbody fusion cage devices has been reported with static devices, and ours is the first report of an expandable TLIF device failure and posterior migration of one of its components.

Methods. The patient is a 30-year-old man who had previously failed 3 lumbar surgical procedures and presented for L5–S1 lumbar fusion with pedicle screws and transforaminal interbody fusion.

Results. Postoperative imaging demonstrated posterior migration of one of the failed expandable interbody components with eventual revision surgery and placement of static transforaminal lumbar interbody fusion cages.

Conclusion. This is the first case report to describe such complication, and caution must be warranted when using these devices.

In this case, we describe the failure of expandable transforaminal lumbar interbody fusion (TLIF) cages. Previous reports have described posterior migration of static cage devices and ours is the first reported migration of an expandable TLIF device.

*Spine Institute of San Diego, San Diego, CA

Cedars-Sinai Medical Center, Los Angeles, CA

Los Angeles Neurosurgical Institute, Beverly Hills, CA.

Address correspondence and reprint requests to Michel Levesque, MD, FRCSC, FACS, Los Angeles Neurosurgical Institute, 8670 Wilshire Blvd., #201, Beverly Hills, CA 90211; E-mail:

Acknowledgment date: February 13, 2012. Acceptance date: March 26, 2012.

The device(s)/drug(s) that is/are the subject of this manuscript is/are not FDA approved for this indication and is/are not commercially available in the United States.

The Staxx XD device is FDA approved as a vertebral body replacement device. We, like the vast majority of surgeons, use it in an off-label manner.

No funds were received in support of this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2012 Lippincott Williams & Wilkins, Inc.