Operative Neurosurgery 29:624–632, 2025
This clinical study evaluates whether “Banana” versus “Bullet” transforaminal lumbar interbody fusion (TLIF) devices produce different immediate postoperative segmental lordosis in one- and two-level degenerative lumbar fusions. Using 241 treated levels from 198 patients, the authors compare radiographic outcomes and perform multivariable regression to identify independent predictors of postoperative segmental lordosis and its change.
Findings show univariable advantages for “Banana” cages in small magnitudes, but multivariable analysis identifies preoperative segmental lordosis, implant-listed lordosis, pelvic incidence, and use of bilateral TLIF windows—not cage morphology—as primary predictors of immediate postoperative segmental correction. The paper recommends further work on subsidence risk and maintenance of correction.
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