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[腰椎椎间融合术后 Cage 下沉的研究进展]

[Advances in research on Cage subsidence following lumbar interbody fusion].

作者信息

Zhao Long, Zeng Jiancheng, Xie Tianhang, Pu Xingxiao, Lu Yufei

机构信息

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Aug 15;35(8):1063-1067. doi: 10.7507/1002-1892.202104036.


DOI:10.7507/1002-1892.202104036
PMID:34387439
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8403988/
Abstract

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.

摘要

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。

相似文献

[1]
[Advances in research on Cage subsidence following lumbar interbody fusion].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-8-15

[2]
Poor Bone Quality, Multilevel Surgery, and Narrow and Tall Cages Are Associated with Intraoperative Endplate Injuries and Late-onset Cage Subsidence in Lateral Lumbar Interbody Fusion: A Systematic Review.

Clin Orthop Relat Res. 2022-1-1

[3]
Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review.

J Orthop Surg Res. 2022-4-10

[4]
Subsidence of metal interbody cage after posterior lumbar interbody fusion with pedicle screw fixation.

Orthopedics. 2009-4

[5]
Low Hounsfield units on computed tomography are associated with cage subsidence following oblique lumbar interbody fusion (OLIF).

Spine J. 2022-6

[6]
Influence of coronal-morphology of endplate and intervertebral space to cage subsidence and fusion following oblique lumbar interbody fusion.

BMC Musculoskelet Disord. 2022-7-4

[7]
Lumbar disc height and vertebral Hounsfield units: association with interbody cage subsidence.

Neurosurg Focus. 2020-8

[8]
The predictive value of a novel site-specific MRI-based bone quality assessment, endplate bone quality (EBQ), for severe cage subsidence among patients undergoing standalone lateral lumbar interbody fusion.

Spine J. 2022-11

[9]
Risk factors for cage migration and cage retropulsion following transforaminal lumbar interbody fusion.

Spine J. 2018-8-22

[10]
Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion.

J Orthop Surg Res. 2021-10-11

引用本文的文献

[1]
Perioperative Denosumab Versus Bisphosphonates for MIDLF Surgery in Patients With Osteopenia: A Short-Term Prospective Cohort Study.

Global Spine J. 2025-9-4

[2]
Single-position oblique lumbar interbody fusion with navigation: improved efficiency and screw accuracy compared to dual-position with fluoroscopy.

Sci Rep. 2024-7-23

[3]
Finite element biomechanical analysis of 3D printed intervertebral fusion cage in osteoporotic population.

BMC Musculoskelet Disord. 2024-2-12

[4]
Factors associated with intervertebral cage subsidence in posterior lumbar fusion.

J Orthop Surg Res. 2024-1-3

[5]
[Efficacy analysis of autologous facet joint bone block in lumbar interbody fusion of osteoporosis patients].

Beijing Da Xue Xue Bao Yi Xue Ban. 2023-10-18

[6]
[Research progress on the influence of Modic changes on lumbar interbody fusion and its treatment measure].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-8-15

[7]
Biomechanical evaluation of different sizes of 3D printed cage in lumbar interbody fusion-a finite element analysis.

BMC Musculoskelet Disord. 2023-2-1

[8]
[Research progress of effect of cage height on outcomes of lumbar interbody fusion surgery].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022-11-15

[9]
[Application of three-dimensional printed porous titanium alloy cage and poly-ether-ether-ketone cage in posterior lumbar interbody fusion].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022-9-15

[10]
Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review.

J Orthop Surg Res. 2022-4-10

本文引用的文献

[1]
Importance of the epiphyseal ring in OLIF stand-alone surgery: a biomechanical study on cadaveric spines.

Eur Spine J. 2021-1

[2]
Risk Factors of Cage Subsidence in Patients Received Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Spine (Phila Pa 1976). 2020-10-1

[3]
Factors Influencing Early Disc Height Loss Following Lateral Lumbar Interbody Fusion.

Asian Spine J. 2020-10

[4]
Subsidence induced recurrent radiculopathy after staged two-level standalone endoscopic lumbar interbody fusion with a threaded cylindrical cage: a case report.

J Spine Surg. 2020-1

[5]
Cage subsidence in lateral interbody fusion with transpsoas approach: intraoperative endplate injury or late-onset settling.

Spine Surg Relat Res. 2017-11-27

[6]
Subsidence Rates After Lateral Lumbar Interbody Fusion: A Systematic Review.

World Neurosurg. 2019-2

[7]
Effect of osteoporosis on the clinical and radiological outcomes following one-level posterior lumbar interbody fusion.

J Orthop Sci. 2018-11

[8]
Risk factors for cage migration and cage retropulsion following transforaminal lumbar interbody fusion.

Spine J. 2018-8-22

[9]
Incidence and clinical relevance of cage subsidence in anterior cervical discectomy and fusion: a systematic review.

Acta Neurochir (Wien). 2018-4

[10]
Bisphosphonate and Teriparatide Use in Thoracolumbar Spinal Fusion: A Systematic Review and Meta-analysis of Comparative Studies.

Spine (Phila Pa 1976). 2018-9-1

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