Advances in Hounsfield units value for predicting cage subsidence on spinal interbody fusion surgery

Pu, Xingxiao; Wang, Daxing; Gu, Shao

doi:10.1007/s00586-023-07805-2

Cited by 7 publications

(3 citation statements)

References 36 publications

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“…An increasing number of studies have reported osteoporosis as a risk factor for cage subsidence, a finding supported by our review and others [ 70 , 71 ]. In osteoporotic patients, compromised vertebral strength, decreased endplate failure loads, and increased stress concentration within the surgical segment all contribute to failure at the cage-endplate interface.…”

Section: Discussionsupporting

confidence: 88%

The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review

Filley,

Baldwin,

Ben-Natan

et al. 2024

North American Spine Society Journal (NASSJ)

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Section: Discussionsupporting

confidence: 88%

The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review

Filley,

Baldwin,

Ben-Natan

et al. 2024

North American Spine Society Journal (NASSJ)

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“…10 Osteoporosis may jeopardize the strength of the endplates leading to higher rates of fracture and subsidence of the spacer into the vertebral body. Pu et al 11 performed a recent review of 37 studies and determined that poor bone quality is associated with a significantly increased risk of cage subsidence after interbody fusion.…”

Section: Osteoporosis and Cage Subsidencementioning

confidence: 99%

Bone Quality in Spinal Surgery: Evaluation, Implications, and Treatments

Raad,

Satin,

Derman

2024

Contemporary Spine Surgery

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Bone mineral density (BMD) is generally defined as the concentration or density of bone minerals in bone tissue. It is an indicator of bone quality and is used in the diagnosis of osteopenia or osteoporosis. Poor bone quality has been demonstrated to be associated with significantly higher risk of fragility fractures including those of the hip, distal radius, and spine. It is important for spinal surgeons to understand the implications of BMD on outcomes after spinal surgery, learn the various methods to evaluate it, and be aware of treatment options in the perioperative period.

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“…Given the conflicting results regarding the subsidence of expandable cages, a cautious approach is warranted. Excessive expansion of the cages within a narrow disc space may damage the vertebral body endplates, especially in patients with osteoporosis or osteopenia [66], underscoring the need for careful consideration during the expansion process.…”

Section: Complications and Drawbacks Of Expandable Cagesmentioning

confidence: 99%

Expandable Cages for Lumbar Interbody Fusion: A Narrative Review

Lee,

Yoon,

Park

et al. 2024

JCM

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Lumbar fusion surgery for treating degenerative spinal diseases has undergone significant advancements in recent years. In addition to posterior instrumentation, anterior interbody fusion techniques have been developed along with various cages for interbody fusion. Recently, expandable cages capable of altering height, lordotic angle, and footprint within the disc space have garnered significant attention. In this manuscript, we review the current status, clinical outcomes, and future prospects of expandable cages for lumbar interbody fusion based on the existing literature. Expandable cages are suitable for minimally invasive spinal surgeries. Small-sized cages can be inserted and subsequently expanded to a larger size within the disc space. While expandable cages generally demonstrate superior clinical outcomes compared to static cages, some studies have suggested comparable or even poorer outcomes with expandable cages than static cages. Careful interpretation through additional long-term follow-ups is required to assess the utility of expandable cages. If these shortcomings are addressed and the advantages are further developed, expandable cages could become suitable surgical instruments for minimally invasive spinal surgeries.

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Advances in Hounsfield units value for predicting cage subsidence on spinal interbody fusion surgery

Cited by 7 publications

References 36 publications

The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review

The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review

Bone Quality in Spinal Surgery: Evaluation, Implications, and Treatments

Expandable Cages for Lumbar Interbody Fusion: A Narrative Review

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