Repeated Migration of a Fusion Cage after Posterior Lumbar Interbody Fusion

Lee, Jun Gue; Lee, Sung Myung; Kim, Seok Won; Shin, Ho Seong

doi:10.14245/kjs.2013.10.1.25

Cited by 11 publications

(11 citation statements)

References 6 publications

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“…Additionally, increasing numbers of cage migration is reported when stand-alone cages were used. Though repeated migration of cage after posterior lumbar interbody fusion has been reported 23) , the rate of cage migration in patients with no posterior instrumentation was significantly higher compared with the rate in those with posterior instrumentation (16.7% vs. 0%) 30) . We have observed relatively low of perioperative complications including hardware problems after PLIF using stand-alone cages, which could be due to low rate of cage retropulsion, may be related to the threaded cage appearance.…”

Section: Discussionmentioning

confidence: 90%

Mid-term Clinical Outcomes of Stand-alone Posterior Interbody Fusion with Rectangular Cages: A 4-year-minimum Follow-up

et al. 2013

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ObjectiveWe sought to determine minimum 4 years of clinical outcomes including fusion rate, revision rate and complications of patients who underwent placement of rectangular stand-alone cages.MethodsThirty-three cases of degenerative spine that had been followed for at least 4-years were reviewed retrospectively. Cages were inserted at L4-L5 level or L5-S1 in 27 or in 6 cases respectively. Visual analogue scale (VAS), Odom's criteria, fusion rate, intervertebral disc height and lumbar lordosis were determined pre- and post-operatively on standing x-rays. Amount of intra- and postoperative blood loss, total volume transfused, duration of surgery and perioperative complications were also evaluated.ResultsThe mean VAS score of back pain and sciatica were improved from 8.0 and 7.0 points to 3.4 and 2.4 during 1 years follow-up visit and the scores was raised gradually. Also, during the follow-up, 94% of patients showed excellent or good outcomes by the Odom's criteria. Intervertebral disc height was increased from 8.2±1.4mm to 9.2±1.9mm at the first year of follow-up, however, found to be decreased and stabilized to 8.3±1.8mm after 2 years. The fusion rate was approximately 91% after 4 year postoperative. The segmental angle of lordosis was increased significantly by two years but it was not maintained after four years. A statistically insignificant change in total lumbar lordosis was also observed. Three patients (9%) had experienced perioperative complications.ConclusionThe use of rectangular stand-alone cages for posterior lumbar interbody fusion (PLIF) resulted in a various degree of subsidence and demonstrate very low complication rate, high functional stability and improved clinical outcomes in patients with degenerative lumbar disc disease.

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Section: Discussionmentioning

confidence: 90%

Mid-term Clinical Outcomes of Stand-alone Posterior Interbody Fusion with Rectangular Cages: A 4-year-minimum Follow-up

et al. 2013

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“…Nevertheless, other authors reported similar results. Li et al [20] and Lee et al [21] showed that lower BMD could result in cage migration. Pan et al [22] and Lee et al [23] reported that BMI of patients with cage retropulsion was higher than that in those without.…”

Section: Discussionmentioning

confidence: 99%

Standalone oblique lateral interbody fusion vs. combined with percutaneous pedicle screw in spondylolisthesis

Sun

et al. 2020

BMC Musculoskelet Disord

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Background: To compare standalone oblique lateral interbody fusion (OLIF) vs. OLIF combined with posterior bilateral percutaneous pedicle screw fixation (OLIF combined) for the treatment of lumbar spondylolisthesis. Methods: This was a retrospective study of patients who underwent standalone OLIF or combined OLIF between 07/2014 and 08/2017 at two hospitals in China. Direct decompressions were not performed. Visual analog scale (VAS), Oswestry Disability Index (ODI), satisfaction rate, anterior/posterior disc heights (DH), foraminal height (FH), foraminal width (FW), cage subsidence, cage retropulsion, fusion rate, and complications were analyzed. All imaging examinations were read independently by two physicians and the mean measurements were used for analysis. Results: A total of 73 patients were included: 32 with standalone OLIF and 41 with combined OLIF. The total complication rate was 25.0% with standalone OLIF and 26.8% with combined OLIF. There were no differences in VAS and ODI scores by 2 years of follow-up, but the scores were better with standalone OLIF at 1 week and 3 months (P < 0.05). PDH and FW was smaller in the combined OLIF group compared with the standalone OLIF group before and after surgery (all P < 0.05). There were significant differences in FH before surgery and at 1 week and 3 months between the two groups (all P < 0.05), but the difference disappeared by 2 years (P = 0.111). Cage subsidence occurred in 7.3% (3/41) and 7.3% (3/41) of the patients at 3 and 24 months, respectively, in the combined OLIF group, compared with 6.3% (2/32) and 15.6% (5/32), respectively, in the standalone OLIF group at the same time points (P = 0.287). There was no cage retropulsion in both groups at 2 years. The fusion rate was 85.4%(35/41) in the combined OLIF group and 84.4% (27/32) in the standalone OLIF group at 3 months(P = 0.669). At 24 months, the fusion rate was 100.0% in the combined OLIF group and 93.8% (30/32) in the standalone OLIF group (P = 0.066).

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“…Very severe complications may be seen in spinal surgery due to the proximity of the spinal cord and vascular structures to the operative field. The use of posterior transpedicular screw systems (PTSS) and PLIFC has gradually increased for treatment of spinal instability and/or spinal stenosis and related complications have also increased [ 1 , 2 , 5 – 7 ]. Classical complications of PLIFC include spinal root injury, dura injury, epidural fibrosis and/or arachnoiditis, infection, and cage migration.…”

Section: Discussionmentioning

confidence: 99%

“…PLIFC migrations are usually observed during the postoperative period, just after the mobilization of the patient and usually toward spinal canal [ 1 ]. The main cause of posterior migration of PLIFCs is total facetectomy and insufficiency of posterior stabilization [ 4 , 5 ]. Migration to the retroperitoneal region is a rare condition in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…The posterior lumbar interbody fusion cage (PLIFC) was shown to enhance spinal fusion and to prevent pseudoarthrosis due to its basic dynamic characteristics [ 3 ]. In addition, the PLIFC enables the restoration of disc height and decompression of neural structures by providing anterior support to the vertebral column in degenerative lumbar spinal diseases [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative antepulsion of a posterior lumbar interbody fusion cage: three case reports

Ceylan¹,

Yaldız²,

Asil³

et al. 2015

Pan Afr Med J

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Spinal fusion surgery techniques develop together with technologic advancements. New complications are seen as the result of new techniques and these may be very severe due to spinal cord and vascular structures in the lumbar region. The posterior lumbar interbody fusion cage (PLIFC) was shown to enhance spinal fusion and to prevent pseudoarthrosis due to its basic dynamic characteristics. PLIFC migrations are usually observed during the postoperative period, just after the mobilization of the patient and usually toward spinal canal. Migration to the retroperitoneal region is a extremely rare condition in the literature. In this article we discussed three cases of PLIFC antepulsion into the retroperitoneal region during the intraoperative period.

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Repeated Migration of a Fusion Cage after Posterior Lumbar Interbody Fusion

Cited by 11 publications

References 6 publications

Mid-term Clinical Outcomes of Stand-alone Posterior Interbody Fusion with Rectangular Cages: A 4-year-minimum Follow-up

Mid-term Clinical Outcomes of Stand-alone Posterior Interbody Fusion with Rectangular Cages: A 4-year-minimum Follow-up

Standalone oblique lateral interbody fusion vs. combined with percutaneous pedicle screw in spondylolisthesis

Intraoperative antepulsion of a posterior lumbar interbody fusion cage: three case reports

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