Focus of the Report: This Health Technology Assessment focuses on expandable interbody cages (EICs) for cervical fusion in patients with degenerative disc disease (DDD).
Technology Description: Interbody fusion procedures involve the removal of a pathologic disc and insertion of interbody cages and bone grafts, with the aim of stabilizing the spine by fusing 2 or more vertebrae together. Interbody cages for spinal fusion may be composed of titanium or radiopaque polyetheretherketone. Static interbody spacers have traditionally been used for spinal interbody fusion procedures. EICs are an alternative option designed to be inserted at a minimal profile, then expanded while in the intervertebral space.
Controversy: Although spinal fusion has become standard surgical care for patients with DDD who have failed more conservative treatments and who meet other strict criteria, there remains controversy over the efficacy and safety of fusion, criteria for selection of which patients benefit most, and surgical protocols. A wide range of instrumentation and grafting materials are in use for spinal fusion procedures and the comparative safety and effectiveness of EICs versus alternative therapies is unclear.
Are expandable interbody fusion devices effective in improving health outcomes in patients with degenerative disc disease (DDD), spondylolisthesis, spinal stenosis, or other indications for cervical spinal fusion?
Are cervical expandable interbody fusion devices safe?
How do cervical expandable interbody fusion devices compare with standard care?
Have definitive patient selection criteria been established for use of EICs in patients with DDD or other indications for cervical spinal fusion?
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