WU Haihao,ZHOU Chunguang,TANG Tao.The relationship between cage subsidence and lumbar sagittal alignment after oblique lumbar interbody fusion stand-alone[J].Chinese Journal of Spine and Spinal Cord,2022,(2):128-134.
The relationship between cage subsidence and lumbar sagittal alignment after oblique lumbar interbody fusion stand-alone
Received:July 19, 2021  Revised:January 20, 2022
English Keywords:Oblique lumbar interbody fusion  Cage subsidence  Lumbar lordosis  Lumbar sagittal alignment
Fund:浙江省医药卫生科技计划项目(编号2019KY178);宁波市自然科学基金项目(编号2019A610241)
Author NameAffiliation
WU Haihao Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences(Ningbo No. 2 Hospital), Ningbo, 315010, China 
ZHOU Chunguang 中国科学院大学宁波华美医院骨科 315010 宁波市 
TANG Tao 中国科学院大学宁波华美医院骨科 315010 宁波市 
刘军辉  
陈意磊  
范顺武  
赵凤东  
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English Abstract:
  【Abstract】 Objectives: The purpose of this study was to assess the relationship between cage subsidence and lumbar sagittal alignment after oblique lumbar interbody fusion(OLIF) stand-alone. methods: In this study,the clinical data of 117 consecutive patients who underwent OLIF stand-alone were reviewed. Subsidence was classified using the following scale: grade 0, 0%-24% loss of postoperative disc height(DH); grade Ⅰ, 25%-49%; grade Ⅱ, 50%-74%; and grade Ⅲ, 75%-100%. All the patients were followed up for more than 2 years. DH improvement(postoperative DH-preoperative DH), segmental lordosis(SL) improvement(postoperative SL-preoperative SL), lumbar lordosis(LL) improvement(postoperative LL-preoperative LL) were evaluated, decrease of postoperative SL and LL were also recorded. Visual analogue scale(VAS) and Oswestry disability index(ODI) were compared. Logistic regression for cage subsidence after OLIF stand-alone was done. Results: All the operations were successfully done. 106 patients had grade 0 subsidence, 11 patients had grade Ⅰ subsidence, there was no grade Ⅱ, grade Ⅲ subsidence. 5 patients with grade Ⅰ subsidence underwent reoperation. The DH improvement and SL improvement in grade Ⅰ subsidence group was significantly larger than that in grade 0 subsidence group(P<0.05). There was no significant difference in LL improvement in the two groups(P>0.05), DH improvement and SL improvement are independent risk factors for cage subsidence. The SL decrease and LL decrease in grade Ⅰ subsidence group was significantly larger than that in grade 0 subsidence group(P<0.05). There was a significant decrease in VAS and ODI at all examinations postoperation(P<0.05), When comparing the two groups, The VAS scores and ODI scores in grade Ⅰ subsidence group was larger than that in grade 0 subsidence group at 1 month follow-up, but without statistical significance. The VAS scores and ODI scores in grade Ⅰ subsidence group was significantly larger than that in grade 0 subsidence group at the final follow-up(P<0.05). Conclusions: In OLIF stand-alone, excessive reconstruction of DH and SL may lead to cage subsidence. Cage subsidence could result in SL and LL decrease, and affect clinical outcome.
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