Department of Spine Surgery, Tianjin Hospital, Tianjin, China.
Orthop Surg. 2012 Feb;4(1):11-4. doi: 10.1111/j.1757-7861.2011.00164.x.
Anterior lumbar interbody fusion (ALIF) has increased in popularity because it has advantages over posterior fusion. Because there is disagreement about the stability of stand-alone cage ALIF, some surgeons use various types of supplementary fixation, including anterior plates, pedicle screw systems and translaminar screws, to increase segmental stability. Many factors associated with both the cages and endplates influence the time of onset and extent of subsidence after use of stand-alone cage ALIF. A large round cage with an adequate central opening is recommended to facilitate maximum contact with the periphery of the endplate. With regard to the relationship between radiographic fusion and recurrence of symptoms with the development of subsidence, most researchers have reported finding no correlation. Subsidence may be due to a process of bone incorporation between cages and endplates. Does subsidence or nonfusion really matter clinically? Further prospective, randomized controlled trials are very much needed to answer these questions.
前路腰椎体间融合术（ALIF）的应用日益增多，因为它比后路融合具有优势。由于对单纯 cage ALIF 的稳定性存在分歧，一些外科医生使用各种类型的补充固定物，包括前路板、椎弓根螺钉系统和经椎板螺钉，以增加节段稳定性。许多与 cage 和终板相关的因素都会影响使用单纯 cage ALIF 后沉降的开始时间和程度。建议使用大的圆形 cage，并带有足够的中央开口，以方便与终板的外围最大程度接触。关于影像学融合与症状复发与沉降发展之间的关系，大多数研究人员报告发现没有相关性。沉降可能是 cage 和终板之间骨结合的过程。沉降或不融合在临床上真的重要吗？需要进一步进行前瞻性、随机对照试验来回答这些问题。
