Zhao Long, Zeng Jiancheng, Xie Tianhang, Pu Xingxiao, Lu Yufei
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Aug 15;35(8):1063-1067. doi: 10.7507/1002-1892.202104036.
OBJECTIVE: To summarize the advances in research on Cage subsidence following lumbar interbody fusion, and provide reference for its prevention. METHODS: The definition, development, clinical significance, and related risk factors of Cage subsidence following lumbar interbody fusion were throughout reviewed by referring to relevant domestic and doreign literature in recent years. RESULTS: At present, there is no consensus on the definition of Cage subsidence, and mostly accepted as the disk height reduction greater than 2 mm. Cage subsidence mainly occurs in the early postoperative stage, which weakens the radiological surgical outcome, and may further damage the effectiveness or even lead to surgical failure. Cage subsidence is closely related to the Cage size and its placement location, intraoperative endplate preparation, morphological matching of disk space to Cage, bone mineral density, body mass index, and so on. CONCLUSION: The appropriate size and shape of the Cage usage, the posterolateral Cage placed, the gentle endplate operation to prevent injury, the active perioperative anti-osteoporosis treatment, and the education of patients to control body weight may help to prevent Cage subsidence and ensure good surgical results.
目的:总结腰椎椎间融合术后Cage下沉的研究进展,为其预防提供参考。 方法:通过查阅近年来国内外相关文献,对腰椎椎间融合术后Cage下沉的定义、发展、临床意义及相关危险因素进行全面综述。 结果:目前,对于Cage下沉的定义尚无共识,大多认为椎间盘高度降低大于2mm。Cage下沉主要发生在术后早期,削弱了影像学手术效果,可能进一步损害手术有效性甚至导致手术失败。Cage下沉与Cage大小及其放置位置、术中终板准备、椎间盘间隙与Cage的形态匹配、骨密度、体重指数等密切相关。 结论:使用尺寸和形状合适的Cage,放置于后外侧,轻柔进行终板操作以防止损伤,积极进行围手术期抗骨质疏松治疗,以及对患者进行控制体重的教育,可能有助于预防Cage下沉并确保良好的手术效果。
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