A study of 168 consecutive patients undergoing minimally invasive transforaminal lumbar interbody fusion found secondary cage collapse in 20.5% of patients who received the Catalyft PL expandable cage, compared with 1.8% of those who received the X-PAC cage.
The retrospective, nonrandomized study included 112 patients who received 144 Catalyft PL cages and 56 patients who received 80 X-PAC cages. The difference in patient-level secondary collapse was statistically significant, with a relative risk of 11.5 and P=0.001, according to the study, published online Sept. 10 in the Journal of Spine Surgery.
At the cage level, secondary collapse occurred in 16.7% of Catalyft PL cages and 1.2% of X-PAC cages. Subsidence occurred in 32.1% of Catalyft PL patients and 14.3% of X-PAC patients, though the patient-level subsidence comparison did not remain significant after Bonferroni correction.
The findings come after a 2025 FDA Class II recall of the Catalyft PL system involving potential cage height loss or collapse, which the study authors cited in calling for cautious device selection and independent prospective validation.
The authors cautioned that the single-surgeon cohorts were treated sequentially and differed in cage geometry. They said the findings demonstrate an association rather than a causal effect.
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