Evaluating the Efficacy of a Novel Titanium Cage System in ALIF and LLIF: A Retrospective Clinical and Radiographic Analysis

<b>Background/Objectives</b>: The success of lumbar interbody fusion depends on the implant design and the surgical approach used. This study evaluated the clinical and radiographic outcomes of lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF) using a 3D-printed porous titanium interbody cage system. <b>Methods</b>: A retrospective, single-center review of 48 patients treated for degenerative lumbar spine disease was conducted. Patients underwent LLIF, ALIF, or a combination of both using a 3D-printed titanium cage system (J&J MedTech, Raynham, MA, USA). The Oswestry disability index (ODI) and Patient-Reported Outcomes Measurement Information System (PROMIS) metrics were assessed after 6 weeks, 3 months, 6 months, and 12 months. Linear mixed-effects models evaluated the pre- and post-operative differences. Fusion performance and complications were assessed using the Bridwell grading system over 24 months. <b>Results</b>: A total of 78 levels (62 LLIF and 16 ALIF) were analyzed. Fusion rates were 90.3% (56/62) for LLIF levels and 81.3% (13/16) for ALIF levels by the end of 12 months. ODI scores improved significantly after 3 months (MD -13.0, <i>p</i> < 0.001), 6 months (MD -12.3, <i>p</i> < 0.001), and 12 months (MD -14.9, <i>p</i> < 0.001). PROMIS Pain Interference scores improved after 3 months (MD -6.1, <i>p</i> < 0.001), 6 months (MD -3.4, <i>p</i> < 0.001), and 12 months (MD -5.8, <i>p</i> < 0.001). PROMIS Physical Function scores improved after 3 months (MD +3.4, <i>p</i> = 0.032) and 12 months (MD +4.9, <i>p</i> < 0.001). <b>Conclusions</b>: This novel interbody cage demonstrated high fusion rates, significant pain and function improvements, and a favorable safety profile, warranting further comparative studies.