Risk Factors of Cage Subsidence after Posterior Lumbar Interbody Fusion

Lee, Dong Hoon; Jeong, Soon‐Taek; Hong, Chang-Hwa; Choi, Young-Lac; Kang, Byeong-Hun; Kim, Dong‐Hee

doi:10.4184/jkss.2016.23.2.100

Cited by 7 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies investigating posterior lumbar fusion identified low BMI, diabetes mellitus, osteoporosis, loosening of posterior instrumentation, and pear-shaped disc as potential risk factors for subsidence. 14,30 In addition to that, posterior screw fixation, the size and shape of the interbody cage, and the number of spinal levels fused, could impact the biomechanics of the lumbar spine following posterior fusion. 31,32 However, none of the studies included in this meta-analysis present-ed a comparative analysis of PEEK vs. Ti to study the effect of potential risk factors across the types of interbody cages.…”

Section: Discussionmentioning

confidence: 99%

“…Four studies were carried out in Germany, 17,20,27,28 4 studies in Japan, 13,16,18,19 1 study in Italy, 12 1 study in China, 15 1 study in the United Kingdom (Table 1). 14 The data of 1,094 patients was analyzed in this meta-analysis, of which 673 (61.5%) had lumbar interbody fusion using a Ti Full-text articles excluded, with reasons (n = 56)…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Lumbar fusion was performed for a total of 1,094 patients (Ti-421, PEEK-673). PLIF was performed in 5 studies 13,15,18,27,28 for 390 patients (35.64%) (Ti-165, PEEK-225) and transforaminal interbody fusion (TLIF) in 6 studies 12,14,16,17,19,20,29 for 704 patients (64.36%) (Ti-256, PEEK-448). The different types of interbody cages used were summarized in Table 1, revealing 3 studies us-ing Ti-coated PEEK cages.…”

Section: Posterior Lumbar Fusionmentioning

confidence: 99%

“…8,9 Despite that, PEEK is chemically inert with limited cell adhesion and fixation to bone. 10 The characteristics and clinical outcomes of Ti and PEEK cages for lumbar spinal fusion were explored in several studies, [11][12][13][14][15][16][17][18][19][20] but the findings were largely inconsistent regarding fusion and subsidence rates. Hence, this study presents a systematic review and meta-analysis to evaluate the clinical outcomes of interbody cages in posterior lumbar fusion surgery.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Polyetheretherketone Versus Titanium Cages for Posterior Lumbar Interbody Fusion: Meta-Analysis and Review of the Literature

et al. 2020

View full text Add to dashboard Cite

Objective: Lumbar fusion with implantation of interbody cage is a common procedure for treatment of lumbar degenerative disease. This study aims to compare the fusion and subsidence rates of titanium (Ti) versus polyetheretherketone (PEEK) interbody cages after posterior lumbar interbody fusion and investigate the effect of clinical and radiological outcomes following fusion on patient-reported outcomes. Methods: A systematic search strategy of 4 electronic databases (MEDLINE, Embase, Web of Science, and Cochrane) was conducted using different MeSH (medical subject headings) terms until January 2020. Pooled odds ratios (ORs) with 95% confidence intervals (CI) were calculated using fixed and random-effect models based upon the heterogeneity (I 2 ) to estimate the association between interbody cages and the measured outcomes. Results: A total of 1,094 patients from 11 studies were reviewed. The final analysis included 421 patients (38.5%) who had lumbar surgery using a Ti and/or a Ti-coated interbody cage and 673 patient (61.5%) who had lumbar surgery using a PEEK cage. Overall, PEEK interbody devices were associated with a significantly lower fusion rate compared with Ti interbody devices (OR, 0.62; 95% CI, 0.41-0.93; p = 0.02). There was no difference in subsidence rates between Ti and PEEK groups (OR, 0.91; 95% CI, 0.54-1.52; p = 0.71). Also, there were no statistically significant differences in visual analogue scale (VAS)-low back pain (p = 0.14) and Japanese Orthopedic Association scale (p = 0.86) between the 2 groups. However, the PEEK group had lower odds of leg pain after surgery compared to the Ti group (OR [VAS-leg], 0.61; 95% CI, 0.28-0.94; p = 0.003). Conclusion: Ti and Ti-coated PEEK cages used for posterior lumbar interbody fusion are associated with similar rates of subsidence, but a higher rate of fusion compared to PEEK interbody cages. Randomized controlled trials are needed to better assess the effect of cage materials and potential factors that could influence the outcomes of interbody lumbar fusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Posterior Lumbar Fusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Polyetheretherketone Versus Titanium Cages for Posterior Lumbar Interbody Fusion: Meta-Analysis and Review of the Literature

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Patient factors increasing the risk of subsidence include high body mass index and low bone mineral density. 14 Studies have shown that oral bisphosphonate given post-operatively could decrease the incidence of cage subsidence. 15 Oxland et al found that the removal of vertebral endplate reduces local strength and stiffness magnitudes in L3-L5 vertebral bodies, leading to an increased risk of implant subsidence.…”

Section: Cage Subsidencementioning

confidence: 99%

Oblique lumbar interbody fusion in management of lumbar degenerative spinal stenosis in Chinese population

Cheung

2020

Journal of Orthopaedics, Trauma and Rehabilitation

View full text Add to dashboard Cite

Purpose: The purpose of this study was to assess the outcomes of a cohort of local Chinese patients who underwent oblique lumbar interbody fusion (OLIF) surgery for lumbar degenerative diseases. Methods: We adopted a minimally invasive anterior approach to the lumbar spine through retroperitoneal access. In the first part of the surgery, a 3- to 5-cm left lateral incision over the abdomen was made guided by imaging. L2–L5 disc space was approached via the corridor between the left psoas muscle and the great vessels. A specially designed interbody cage filled with bone substitute was utilized for interbody fusion. In the second part of the surgery, posterior instrumentation with or without decompression, was performed in a prone position. Efficacy and safety of the surgery were studied. Results: A total of 60 patients with the mean age of 68 years underwent OLIF at 83 surgical levels. Their mean operative time was 79 min, and the average blood loss was 84 ml for the OLIF part. The mean length of hospital stay was 5.5 days. Based on plain computed tomography scan obtained at post-operative 6 months, successful fusion was achieved in 82 of the 83 surgical levels. The Oswestry Disability Index for low back pain had a mean reduction of 22.3% after 6 months. Specific complications observed include transient thigh pain or numbness, retroperitoneal hematoma, post-operative ileus and Bone Morphogenetic Protein (BMP) osteolysis. None of the patients experienced infection, symptomatic pseudo-arthrosis, hardware failure, vascular injury, nerve injury, ureteral injury, bowel injury, incisional hernia or death. Conclusion: OLIF is an effective procedure to treat lumbar spinal stenosis and spondylolisthesis with excellent fusion rate and good functional outcome. Complications specific to this procedure are not uncommon, but majority are minor and self-recovery. Proper training is required to minimize potential surgical risks.

show abstract

Endplate volumetric bone mineral density is a predictor for cage subsidence following lateral lumbar interbody fusion: a risk factor analysis

et al. 2021

View full text Add to dashboard Cite

Risk Factors of Cage Subsidence after Posterior Lumbar Interbody Fusion

Cited by 7 publications

References 25 publications

Polyetheretherketone Versus Titanium Cages for Posterior Lumbar Interbody Fusion: Meta-Analysis and Review of the Literature

Polyetheretherketone Versus Titanium Cages for Posterior Lumbar Interbody Fusion: Meta-Analysis and Review of the Literature

Oblique lumbar interbody fusion in management of lumbar degenerative spinal stenosis in Chinese population

Endplate volumetric bone mineral density is a predictor for cage subsidence following lateral lumbar interbody fusion: a risk factor analysis

Contact Info

Product

Resources

About