Beyond stabilization: barriers and opportunities for sagittal alignment correction with transforaminal lumbar interbody fusion – a single tertiary center retrospective study

TLIF can meaningfully contribute to sagittal alignment, especially in patients with poor baseline lordosis. Open procedures and fixed cages provide superior correction, while MIS, expandable cages, subsidence, and higher patient weight limit outcomes. These findings highlight TLIF's underrecognized corrective potential and underscore the importance of tailoring surgical strategy to both patient and alignment goals.