A longitudinal investigation of the endplate cystic lesion effect on oblique lumbar interbody fusion

Lin, Guang‐Xun; Kotheeranurak, Vit; Zeng, Teng-Hui; Mahatthanatrakul, Akaworn; Kim, Jin-Sung

doi:10.1016/j.clineuro.2019.105407

Cited by 12 publications

(14 citation statements)

References 22 publications

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“…Second, the follow-up period was also relatively short. However, previous studies proven the 6-18 weeks were adequate to access cage subsidence [8,15,[19][20][21][22][23][24][25][26][27]. Marchi et al [8] reported 90.2% of cage subsidence was identified at the 6 weeks postoperatively and there was no incidence of subsidence or worsening of subsidence after 3 months postoperatively.…”

Section: Discussionmentioning

confidence: 98%

Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion

et al. 2021

J Orthop Surg Res

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Background For lumbar degenerative diseases, cage subsidence is a serious complication and can result in the failure of indirect decompression in the oblique lumbar interbody fusion (OLIF) procedure. Whether additional lateral plate fixation was effective to improve clinical outcomes and prevent cage subsidence was still unknown. This study aimed to compare the incidence and degree of cage subsidence between stand-alone oblique lumbar interbody fusion (SA-OLIF) and OLIF combined with lateral plate fixation (OLIF + LP) for the treatment of lumbar degenerative diseases and to evaluate the effect of the lateral plate fixation. Methods This was a retrospective comparative study. 20 patients with 21 levels underwent SA-OLIF and 21 patients with 26 levels underwent OLIF + LP. We compared clinical and radiographic outcomes between two groups. Clinical evaluation included Visual Analog Scale (VAS) for back pain and leg pain, Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI). Radiographical evaluation included disc height (DH), segmental lordosis angle (SL), and subsidence rate on standing lateral radiographs. Cage subsidence was classified using Marchi’s criteria. Results The mean follow-up duration was 6.3 ± 2.4 months. There were no significant differences among perioperative data (operation time, estimated intraoperative blood loss, and complication), clinical outcome (VAS, ODI, and JOA) and radiological outcome (SH and SL). The subsidence rate was 19.0% (4/21) in SA-OLIF group and 19.2% (5/26) in OLIF + LP group. 81.0% in SA-OLIF group and 80.8% in OLIF + LP group had Grade 0 subsidence, 14.3% in SA-OLIF group and 15.4% in OLIF + LP group had Grade I subsidence, and 4.8% in SA-OLIF group and 3.8% in OLIF + LP group had Grade II subsidence (P = 0.984). One patient with severe cage subsidence and lateral plate migration underwent revision surgery. Conclusions The additional lateral plate fixation does not appear to be more effective to prevent cage subsidence in the oblique lumbar interbody fusion, compared with stand-alone technique. If severe cage subsidence occurs, it may result in lateral plate migration in OLIF combined with lateral plate fixation.

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Section: Discussionmentioning

confidence: 98%

Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion

et al. 2021

J Orthop Surg Res

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“…11,17 However, there is controversy as to whether or not cage subsidence is even a complication, with the idea that this is an expected sequela of LLIF, and clinical and radiographic outcomes are not necessarily compromised by subsidence. 3,11,13 On the other hand, some reports state that subsidence is a significant issue that often necessitates revision surgery because of symptomatic manifestations. 11,18,19 Although many reports have published subsidence rates, there is no single, established method to measure subsidence, with many papers using different methods such as CT and radiography.…”

Section: Discussionmentioning

confidence: 99%

“…11 Previous reports have shown that older age, female sex, endplate injury, endplate cystic lesion (Schmorl's nodes), cage size, unilateral pedicle screw fixation, and osteoporosis may be risk factors for cage subsidence. [1][2][3][4]22 Because osteoporosis reflects low BMD, it is important to consider BMD prior to LLIF. [23][24][25] As a general rule, bone density is measured by DXA, but not all patients obtain a preoperative DXA scan.…”

Section: Discussionmentioning

confidence: 99%

The association between lower Hounsfield units on computed tomography and cage subsidence after lateral lumbar interbody fusion

Mummaneni²,

Wang³

et al. 2020

Neurosurgical Focus

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OBJECTIVEOne vexing problem after lateral lumbar interbody fusion (LLIF) surgery is cage subsidence. Low bone mineral density (BMD) may contribute to subsidence, and BMD is correlated with Hounsfield units (HUs) on CT. The authors investigated if lower HU values correlated with subsidence after LLIF.METHODSA retrospective study of patients undergoing single-level LLIF with pedicle screw fixation for degenerative conditions at the University of California, San Francisco, by 6 spine surgeons was performed. Data on demographics, cage parameters, preoperative HUs on CT, and postoperative subsidence were collected. Thirty-six–inch standing radiographs were used to measure segmental lordosis, disc space height, and subsidence; data were collected immediately postoperatively and at 1 year. Subsidence was graded using a published grade of disc height loss: grade 0, 0%–24%; grade I, 25%–49%; grade II, 50%–74%; and grade III, 75%–100%. HU values were measured on preoperative CT from L1 to L5, and each lumbar vertebral body HU was measured 4 separate times.RESULTSAfter identifying 138 patients who underwent LLIF, 68 met the study inclusion criteria. All patients had single-level LLIF with pedicle screw fixation. The mean follow-up duration was 25.3 ± 10.4 months. There were 40 patients who had grade 0 subsidence, 15 grade I, 9 grade II, and 4 grade III. There were no significant differences in age, sex, BMI, or smoking. There were no significant differences in cage sizes, cage lordosis, and preoperative disc height. The mean segmental HU (the average HU value of the two vertebrae above and below the LLIF) was 169.5 ± 45 for grade 0, 130.3 ± 56.2 for grade I, 100.7 ± 30.2 for grade II, and 119.9 ± 52.9 for grade III (p < 0.001). After using a receiver operating characteristic curve to establish separation criteria between mild and severe subsidence, the most appropriate threshold of HU value was 135.02 between mild and severe subsidence (sensitivity 60%, specificity 92.3%). After univariate and multivariate analysis, preoperative segmental HU value was an independent risk factor for severe cage subsidence (p = 0.017, OR 15.694, 95% CI 1.621–151.961).CONCLUSIONSLower HU values on preoperative CT are associated with cage subsidence after LLIF. Measurement of preoperative HU values on CT may be useful when planning LLIF surgery.

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“…Moreover, osteoporosis can accelerate bone graft resorption, inhibit and reduce new bone formation, and is harmful to bone fusion ( 20 ). Furthermore, cage subsidence is also a risk factor for nonunion ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Characteristics and hotspots of the 50 most cited articles in the field of pre-psoas oblique lumbar interbody fusion

et al. 2022

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PurposeIn the past decade, the field of pre-psoas oblique lumbar interbody fusion (OLIF) has developed rapidly, and with it, the literature on OLIF has grown considerably. This study was designed to analyze the top 50 articles in terms of the number of citations through bibliometric research to demonstrate the research characteristics and hotspots of OLIF.MethodSearching the Web of Science database yielded the 50 most cited publications in the OLIF field as of July 10, 2022. The publications were ranked according to the number of citations. The following sources were evaluated: the year of publications, the number of citations, authors, countries, institutions, journals, research topics, and keyword hotspots.ResultsThe most productive period was from 2017 to 2020, with 41 articles. The number of citations varied from 10 to 140, with an average of 35.52, and 1,776 citations were found. World Neurosurgery published the most articles (12), China produced the most articles (16), and the Catholic University of Korea produced the most studies (6). The corresponding author who produced the most articles was J.S. Kim (5), and the first author who produced the most publications was S. Orita (3). The main research topics were anatomical morphology, surgical techniques, indications, outcomes, and complications. The top 10 most cited keywords were “complications,” “decompression,” “spine,” “surgery,” “outcomes,” “transpsoas approach,” “spondylolisthesis,” “anterior,” “disease,” and “injury.”ConclusionsCertain articles can be distinguished from others using citation analysis as an accurate representation of their impact due to their long-term effectiveness and peer recognition. With these publications, researchers are provided with research priorities and hotspots through influential literature in the field of OLIF.

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A longitudinal investigation of the endplate cystic lesion effect on oblique lumbar interbody fusion

Cited by 12 publications

References 22 publications

Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion

Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion

The association between lower Hounsfield units on computed tomography and cage subsidence after lateral lumbar interbody fusion

Characteristics and hotspots of the 50 most cited articles in the field of pre-psoas oblique lumbar interbody fusion

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