TITLE:
Radiographic Outcomes and Clinical Complications of Expandable versus Static Spacers in Anterior Lumbar Interbody Fusion: A Retrospective Study
AUTHORS:
William L. Mills, William L. Mills Jr.
KEYWORDS:
Anterior Lumbar Interbody Fusion, Expandable Spacers, Static Spacers, Indirect Decompression
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.16 No.4,
April
23,
2026
ABSTRACT: Objective: To compare radiographic outcomes of anterior lumbar interbody fusion (ALIF) with an expandable interbody spacer with integrated fixation (ESIF) versus a static interbody spacer with integrated anti-migratory blades (SSIB) without posterior fixation. Methods: This retrospective study compared 58 degenerative disc disease patients undergoing 1 - 2 level ALIF with either ESIF (n = 27) or SSIB (n = 31). Radiographic outcomes were compared between groups and against preoperative baselines at 2 weeks, 6 weeks, and at 3, 6, and 12 months. Significance was set at p Results: The anterior disc height (DH) showed a statistically significant difference between the two interbody groups out to 1 year postoperatively, with the ESIF group exhibiting a greater change from the preoperative measurements. Patients treated with ESIF also exhibited a significantly greater increase in middle DH compared to SSIB, which was maintained through 6 months. There were no other meaningful differences in measured radiographic parameters between the interbody groups. There were no intraoperative complications; however, there were 3 (9.7%) reoperations in the SSIB group within the first postoperative year and none in the ESIF group. Conclusions: Patients who underwent ALIF with ESIF showed greater increases in DH during the first postoperative year compared to those with SSIB.