Lordotic cages provided significant increase in operative level segmental lordosis compared to non-lordotic cages although overall lumbar lordosis remained unchanged. Anterior and posterior disc heights were significantly increased by both cages, providing basis for indirect spinal decompression ¹⁾.

Lordotic cage insertion through the lateral transpsoas approach is being used increasingly for restoration of sagittal alignment.

Insertion of a parallel or 10° cage has little effect on lordosis. A 30° cage insertion with ALL release resulted in a modest increase in lordosis (10.5°). The addition of spinous process (SP) resection and facetectomy was needed to obtain a larger amount of correction (26°). None of the cages, including the 30° lordotic cage, caused a decrease in posterior disk height suggesting hyperlordotic cages do not cause foraminal stenosis ²⁾.