Related to the development and diffusion of [[ALIF]] and [[XLIF]], it is possible to correct [[sagittal malalignment]] in selected cases of [[lumbar degenerative discopathy]] with relatively low invasiveness. Still, the [[malposition]] or the inappropriate size of the implanted [[cage]]s may lead to the [[subsidence]] of the [[vertebral endplate]]s with loss of [[correction]] as well as a decrease in the potential to restore [[spinal biomechanics]] in the long run. The aim of a study of Tartara et al. was to evaluate the [[safety]], [[feasibility]], and preliminary clinical and radiological results when using [[custom-made]], [[trabecular titanium cage]]s in [[ALIF]] and [[XLIF]] [[procedure]]s.

They [[prospective]]ly evaluated 18 consecutive [[patient]]s who underwent either an ALIF or an XLIF procedure with the implant of a custom-made, trabecular titanium cage for [[lumbar degenerative disease]] with [[sagittal imbalance]], with a minimum of 1-year clinical and radiological follow-up.

After a mean follow-up of 14 months, the [[Oswestry]] score dropped to a mean of 13 from a preoperative value of 48 (p < 0.0001). [[Lumbar lordosis]] was significantly improved, especially in the lower lumbar segment L4-S1 (+ 11 ± 7°; p < 0.0001). No cases of subsidence were noted.

Custom-made, trabecular titanium cages allowed a segmental, steady, durable sagittal correction via ALIF and XLIF approaches. The absence of cage subsidence at 1 year encourages further studies on a larger cohort with longer follow-up
((Tartara F, Bongetta D, Pilloni G, Colombo EV, Giombelli E. Custom-made
trabecular titanium implants for the treatment of lumbar degenerative discopathy 
via ALIF/XLIF techniques: rationale for use and preliminary results. Eur Spine J.
2019 Nov 6. doi: 10.1007/s00586-019-06191-y. [Epub ahead of print] PubMed PMID:
31696335.
)).