Risk Factors of Cage Subsidence after Posterior Lumbar Interbody Fusion (후방 요추체간 유합술 후 케이지 침강의 위험 인자)

Dong-Yeong Lee (이동영); Jeong Soon-Taek (정순택); Changhwa Hong (홍창화); Dae Cheol Nam (최영락); 강병훈; KIM DONG HEE (김동희)

Risk Factors of Cage Subsidence after Posterior Lumbar Interbody Fusion

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2016, 23(2), pp.100-107
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

Dong-Yeong Lee ¹, Jeong Soon-Taek ², Changhwa Hong ³, Dae Cheol Nam ¹, 강병훈 ¹, KIM DONG HEE ²

¹경상대학교 의학전문대학원 정형외과학교실
²경상대학교
³순천향대학교

Accredited

ABSTRACT

Study Design: Retrospective study. Objectives: The purpose of this study was to evaluate risk factors for subsidence after posterior lumbar interbody fusion (PLIF). Summary of Literature Review: Body mass index (BMI), bone mineral density (BMD), cage characteristics (titanium or poly-ether-etherketone (PEEK)) and degree of disc distraction are risk factors for cage subsidence after PLIF. Materials and Methods: From January 2010 to January 2015, a total of 69 patients (93 segments) who were diagnosed with degenerative lumbar spine disease at the current authors’ institution and underwent follow-up for at least 1 year were included in this retrospective study. Data on all factors related to cage subsidence were taken into consideration. The degree of association for each of the factors was determined through the calculation of odds ratios (ORs) with a 95% confidence interval. Logistic regression analyses were performed. The P-value that represented statistical significance was set below 0.05. Results: There were no significant associations between fused segment level and cage subsidence (p=0.588), nor were there any significant associations between the kind of cage (titanium or PEEK) and cage subsidence (p=0.371). Using logistic regression, the factors with a P-value below the 0.20 level in univariate analyses were included in the multivariate analyses. In multivariate analyses, diabetes mellitus (DM) (p=0.029, OR, 4.524), osteoporosis (p=0.026, OR, 6.046), and degree of disc distraction (p=0.010, OR, 1.446) had significant associations with cage subsidence. In addition, there were significant associations between cage subsidence and instrument failure (p=0.008, OR, 8.235). Conclusions: DM and osteoporosis, which may affect bony structures, have significant associations with cage subsidence after PLIF. Cage insertion with excessive disc distraction during surgery may also affect cage subsidence after PLIF.

KEYWORDS

Lumbar, Degenerative disease, Posterior fusion, Cage subsidence

Citation status

* References for papers published after 2023 are currently being built.

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