The role of expandable cages for vertebral body replacement in surgical treatment of patients with thoracic and lumbar spine injuries: a systematic review

Objective. To perform a systematic analysis of contemporary scientific data characterizing the clinical effectiveness of expandable implants for vertebral body replacement in the complex surgical treatment of patients with thoracic and lumbar spine injuries.

Material and Methods. The search for scientific sources was carried out in accordance with the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA principles in the Cochrane Library, PubMed and Medline databases for  the period 2015–2025 A total of 19 studies on the radiological and functional outcomes of the surgeries involving implantation of expandable spinal cages for thoracic and lumbar spine injuries were analyzed.

Results. The technologies for spinal surgery have been developing rapidly over the recent decades. The improvements in minimally invasive techniques have required modifications to implants including those for anterior support spinal fusion. The implants of transformable geometry which allow the replacement of spinal defects that significantly exceed their original dimensions are of particular interest. The contemporary expandable spinal cages vary in the material they are made from and their transformation mechanisms. The literature describes successful cases of their use in thoracic and lumbar spine injuries. The authors demonstrate favorable surgical outcomes using combinations of screw-assisted fusion and interbody implants.

Conclusion. Expandable spinal cages feature a wide range of applications in the treatment of spinal injuries. The advent of vertical lift mechanisms in intervertebral implants has led to a trend towards modifying surgical techniques, particularly the sequence of intervention stages. Despite differences in approaches, specialists favor minimally invasive implant placement, with radiographic and functional results showing no significant differences.

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