Does Vertebral End Plate Morphology Affect Cage Subsidence After Transforaminal Lumbar Interbody Fusion?

Zhou, Qingshuang; Chen, Xi; Xu, Liang; Song, Li; Du, Changzhi; Sun, Xu; Wang, Bin; Zhu, Zezhang; Qiu, Yong

doi:10.1016/j.wneu.2019.06.195

Cited by 27 publications

(20 citation statements)

References 26 publications

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“…There were 15 studies that discussed cage subsidence after LIF [ 20 , 31 , 32 , 34 , 36 , 37 , 40 , 44 , 45 , 49 – 53 , 55 ], with qualities of moderate ( n = 11) and high ( n = 4). For the 2,558 cages pooled across these studies, 705 cages had subsidence (27.6%).…”

Section: Resultsmentioning

confidence: 99%

“…For the 2,558 cages pooled across these studies, 705 cages had subsidence (27.6%). Thresholds for identification of subsidence varied between 2 and 4 mm across studies [ 20 , 31 , 34 , 37 , 40 , 49 , 51 , 53 , 55 ]. Three studies classified subsidence into four grades based on the loss of disc height after LIF (Grade 0: a loss of 0–24% in disc height; Grade I: 25–49%; Grade II: 50–74%; Grade III: 75–100%), with a loss in disc height of 24% indicative of considerable cage subsidence [ 36 , 44 , 52 ].…”

Section: Resultsmentioning

confidence: 99%

“…All included studies provided the age distribution, sixteen of them recorded sex distribution [ 25 , 32 , 34 , 38 , 41 , 42 , 44 , 47 – 50 , 52 , 53 , 55 , 56 , 81 ], seven included body mass index (BMI) [ 32 , 41 , 44 , 49 , 53 , 55 , 56 ], and three accounted for patients with osteoporosis [ 34 , 41 , 48 ]. The details are listed in Table 4 .…”

Section: Resultsmentioning

confidence: 99%

“…Details of fusion levels were provided in 21 of the 29 included articles, describing 7,355 cages [ 20 , 25 , 31 , 32 , 34 – 39 , 41 – 43 , 45 , 47 , 49 , 51 – 53 , 55 , 56 ]. Qualities ranged from low ( n = 1), moderate ( n = 16), and high ( n = 4).…”

Section: Resultsmentioning

confidence: 99%

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Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Robinson

Ackland

et al. 2022

J Orthop Surg Res

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Background Lumbar interbody fusion (LIF) is an established surgical intervention for patients with leg and back pain secondary to disc herniation or degeneration. Interbody fusion involves removal of the herniated or degenerated disc and insertion of interbody devices with bone grafts into the remaining cavity. Extensive research has been conducted on operative complications such as a failure of fusion or non-union of the vertebral bodies. Multiple factors including surgical, implant, and patient factors influencing the rate of complications have been identified. Patient factors include age, sex, osteoporosis, and patient anatomy. Complications can also be influenced by the interbody cage design. The geometry of the bony endplates as well as their corresponding material properties guides the design of interbody cages, which vary considerably across patients with spinal disorders. However, studies on the effects of such variations on the rate of complications are limited. Therefore, this study aimed to perform a systematic review of lumbar endplate geometry and material property factors in LIF failure. Methods Search keywords included ‘factor/cause for spinal fusion failure/cage subsidence/cage migration/non-union’, ‘lumbar’, and ‘interbody’ in electronic databases PubMed and Scopus with no limits on year of publication. Results In total, 1341 articles were reviewed, and 29 articles were deemed suitable for inclusion. Adverse events after LIF, such as cage subsidence, cage migration, and non-union, resulted in fusion failure; hence, risk factors for adverse events after LIF, notably those associated with lumbar endplate geometry and material properties, were also associated with fusion failure. Those risk factors were associated with shape, concavity, bone mineral density and stiffness of endplate, segmental disc angle, and intervertebral disc height. Conclusions This review demonstrated that decreased contact areas between the cage and endplate, thin and weak bony endplate as well as spinal diseases such as spondylolisthesis and osteoporosis are important causes of adverse events after LIF. These findings will facilitate the selection and design of LIF cages, including customised implants based on patient endplate properties.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Robinson

Ackland

et al. 2022

J Orthop Surg Res

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“…Apparently, the high incidence of damage to the endplates in some studies is due to the fact that the authors used CT scans to verify subsidence, which revealed small degrees of subsidence not detectable with X-ray. In TLIF, the subsidence rate is significantly higher — 15.9% [ 43 ], which is associated with a smaller area of the cage support [ 44 ]. According to some authors, with lateral fusion, there is a significant risk of damage to the endplates when the surgeon installs a large cage in patients with reduced bone density.…”

Section: Resultsmentioning

confidence: 99%

Lumbar Spinal Fusion Using Lateral Oblique (Pre-psoas) Approach (Review)

Aleinik¹,

Mlyavykh²,

Qureshi³

2021

Sovrem Tehnol Med

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Lumbar spinal fusion is one of the most common operations in spinal surgery. For its implementation, anterolateral (pre-psoas) approach (oblique lumbar interbody fusion, OLIF) is now increasingly used due to its high efficacy and safety. However, there is still little information on the clinical and radiological results of using this technique. The aim of the study was to analyze the safety and efficacy of OLIF in the treatment of lumbar spine disorders as presented in the literature. Materials and Methods The systematic electronic search was performed using the Ovid Medline, PubMed, and eLIBRARY.RU electronic databases. The following search key words were used: Oblique Lumbar Interbody Fusion, OLIF, Anterior to Psoas Lumbar Interbody Fusion, and ATP. Results For the final analysis, 17 sources were selected; with a total of 2900 patients. Total complication rate was 13.9% (403 cases). The incidence of severe persistent complications was less than 1%. Based on the data obtained, we compared the clinical and radiological results of OLIF with other lumbar fusion methods. Conclusion OLIF is an effective, versatile, and minimally traumatic option for lumbar fusion with relatively few complications, which makes it superior to other retroperitoneal approaches. However, the OLIF technique is not completely free of complications associated with the ventral approach, and it cannot provide adequate decompression of the spinal canal in all cases. In addition, anterior approach surgery is still of limited use in cases of spinal deformities; adequate correction of deformity is achievable mainly in combination with posterior surgery.

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A nonradiographic strategy to real‐time monitor the position of three‐dimensional‐printed medical orthopedic implants by embedding superparamagnetic Fe₃O₄ particles

Li,

Chen,

et al. 2024

Interdisciplinary Materials

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Monitoring the position of orthopedic implants in vivo is paramount for enhancing postoperative rehabilitation. Traditional radiographic methods, although effective, pose inconveniences to patients in terms of specialized equipment requirements and delays in rehabilitation adjustment. Here, a nonradiographic design concept for real‐time and precisely monitoring the position of in vivo orthopedic implants is presented. The monitoring system encompasses an external magnetic field, a three‐dimensional (3D)‐printed superparamagnetic intervertebral body fusion cage (SIBFC), and a magnetometer. The SIBFC with a polyetheretherketone framework and a superparamagnetic Fe3O4 component was integrally fabricated by the high‐temperature selective laser sintering technology. Owing to the superparamagnetic component, the minor migration of SIBFC within the spine would cause the distribution change of the magnetic induction intensities, which can be monitored in real‐time by the magnetometer no matter in the static states or dynamic bending motions. Besides horizontal migration, occurrences of intervertebral subsidence in the vertical plane of the vertebrae can also be effectively distinguished based on the obtained characteristic variations of magnetic induction intensities. This strategy exemplifies the potential of superparamagnetic Fe3O4 particles in equipping 3D‐printed orthopedic implants with wireless monitoring capabilities, holding promise for aiding patients' rehabilitation.

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Does Vertebral End Plate Morphology Affect Cage Subsidence After Transforaminal Lumbar Interbody Fusion?

Cited by 27 publications

References 26 publications

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Lumbar Spinal Fusion Using Lateral Oblique (Pre-psoas) Approach (Review)

A nonradiographic strategy to real‐time monitor the position of three‐dimensional‐printed medical orthopedic implants by embedding superparamagnetic Fe₃O₄ particles

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Does Vertebral End Plate Morphology Affect Cage Subsidence After Transforaminal Lumbar Interbody Fusion?

Cited by 27 publications

References 26 publications

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Lumbar Spinal Fusion Using Lateral Oblique (Pre-psoas) Approach (Review)

A nonradiographic strategy to real‐time monitor the position of three‐dimensional‐printed medical orthopedic implants by embedding superparamagnetic Fe3O4 particles

Contact Info

Product

Resources

About

A nonradiographic strategy to real‐time monitor the position of three‐dimensional‐printed medical orthopedic implants by embedding superparamagnetic Fe₃O₄ particles