Complete cage migration/subsidence into the adjacent vertebral body after posterior lumbar interbody fusion

Corniola, Marco Vincenzo; Jägersberg, Max; Stienen, Martin N.; Gautschi, Oliver

doi:10.1016/j.jocn.2014.08.017

Cited by 17 publications

(12 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the event of a cage migration, revision surgery, which is technically challenging, is frequently required for patients with neurological symptoms, while the revision outcome is varied. [ 5 , 6 , 11 ]…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of posterior cage migration following decompression and instrumented fusion for degenerative lumbar disorders

Wang

Zhu

et al. 2017

Medicine

View full text Add to dashboard Cite

The aim of this study was to explore the incidence and risk factors for posterior cage migration (PCM) following decompression and instrumented fusion for degenerative lumbar disorders, and hope to provide references in decision making and surgical planning for spine surgeons.By retrieving the medical records from January 2011 to December 2015, 286 patients were retrospectively reviewed. According to the occurrence of PCM, patients were divided into 2 groups: PCM group and non-PCM (N-PCM). To investigate risk values for PCM, 3 categorized factors were analyzed statistically: patient characteristics: age, sex, body mass index, bone mineral density, duration of disease, diagnosis, comorbidity, smoke; surgical variables: surgery time, blood loss, surgical strategy, cage morphology, cage size, surgical segment, fusion number, source of bone graft, surgeon experience; radiographic parameters: preoperative lumbar lordosis, correction of lumbar lordosis, preoperative lumbar mobility, preoperative intervertebral height, change of intervertebral height, Modic changes, paraspinal muscle degeneration.PCM was detected in 18 of 286 patients (6.3%) at follow-up. There was no statistically significant difference between the 2 groups in patient characteristics, except diagnosis, as lumbar spondylolisthesis was more prevalent in PCM group than that in N-PCM group. There was no difference between the 2 groups in surgical variables, except cage size and surgeon experience, as size of cage was smaller in PCM group than that in N-PCM group, and the surgeons with less experience (less than 3 years) were more prevalent in PCM group than that in N-PCM group. There was no statistically significant difference between 2 groups in radiographic parameters. Logistic regression model revealed that less than 3 years of surgeons’ experience, small cage size, and lumbar spondylolisthesis were independently associated with PCM.For patients with lumbar spondylolisthesis, they should be fully informed about the risk of PCM before operation. While for spinal surgeons, large cage should be preferred, and careful manipulation should be adopted, especially for new learners with less than 3-year experience of fusion surgery.

show abstract

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of posterior cage migration following decompression and instrumented fusion for degenerative lumbar disorders

Wang

Zhu

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…We believe that subsidence in most of our patients are due to extensive endplate curettage and preparation .To prevent subsidence, it is recommended to avoid extensive rigorous end plate preparation that may expose weak subchondral bone at the cage bed. 24,18,27,10 Additionally, many studies 25,31 have found the lumbar cage subsidence was attributed to small cage with smaller footprints.…”

Section: Discussionmentioning

confidence: 99%

“…Early mobility and exercise enhance local circulation, promote fusion, and may prevent cage migration. 10,17,19,23,27,33 Surgery: Few small cases series reported for cage migration. 3,8,10,17,33 However, revision surgery for cage subsidence and retropulsion is technically demanding.…”

Section: Retropulsionmentioning

confidence: 99%

Posterior Revision of Lumbar Interbody Fusion Cages Migration: Clinical Case Series and Literature Review

Galhom

Elsawaf

Khattab

2017

Egyptian Spine Journal

View full text Add to dashboard Cite

Background Data: Revision surgery for lumbar interbody cage migration is technically demanding.Cage related complication may lead to failure of fusion. Revision of such morbidity is associated with increased risk of permanent neurological insult. Purpose: To analyze the efficacy of posterior approach and iliac crest auto grafting technique in revision of migrated intervertebral cages. Study Design: Retrospective descriptive clinical case study. , we operated 106 patients underwent posterior lumbar interbody fusion (PLIF) with single cage application per level for treatment of degenerative spondylolisthesis. Of these, 12 patients experiencing cage subsidence and retropulsion. In subsidence, it was graded from 0 to III. Retropulsion was considered if the cage beyond the level of the posterior longitudinal line of the index two vertebrae. Patients were assessed pre-operatively for pain and clinical functional outcome by visual analogue scale (VAS) and Oswestry disability index (ODI), respectively. Patient with VAS score ≥5; at least 20% deterioration on ODI or with the superadded neurological deficit was considered candidates for revision surgery. Results: Cage migration incidence was 11.3%, with subsidence (6.7%), and retropulsion (4.6%) of all patients. The average time for subsidence was 3.3 months (range 2 to 6 months). Five patients with grade-II and III subsidence underwent revision surgery for foraminal decompression, augmenting fixation and adding postero-lateral iliac crest bone graft. Retropulsion was encountered in 4 patients and all needed revision surgery for cage retrieval and redo fusion. Grade-I subsidence could be treated conservatively. All surgically treated patients had a good result in VAS and ODI after a second surgery which maintained during follow up with P<0.05. Conclusion: Migration of posterior lumbar interbody fusion cage into the endplates or spinal canal is usually associated with patient dissatisfaction. Revision surgery indicated for cage retropulsion or high-grade subsidence. The posterior approach is technically demanding, safe, and effective for cage migration revision surgery. (2017ESJ141)

show abstract

“…Cage subsidence is one of the clinical complications for patients following PLIF surgery [20,21]. The subsidence resistance of the AM cages needs to be optimized before determining their porous structure.…”

Section: Shape Optimizations For Subsidence Resistance Of Am Cagesmentioning

confidence: 99%

Biomechanical investigation into the structural design of porous additive manufactured cages using numerical and experimental approaches

Tsai

Hsu

Chen

et al. 2016

Computers in Biology and Medicine

View full text Add to dashboard Cite

Complete cage migration/subsidence into the adjacent vertebral body after posterior lumbar interbody fusion

Cited by 17 publications

References 5 publications

Incidence and risk factors of posterior cage migration following decompression and instrumented fusion for degenerative lumbar disorders

Incidence and risk factors of posterior cage migration following decompression and instrumented fusion for degenerative lumbar disorders

Posterior Revision of Lumbar Interbody Fusion Cages Migration: Clinical Case Series and Literature Review

Biomechanical investigation into the structural design of porous additive manufactured cages using numerical and experimental approaches

Contact Info

Product

Resources

About