Spine Department, Schön Klinik Lorsch, Wilhelm Leuschner Strasse 10, Lorsch, Germany.
ARM Advanced Medical Research, Hofenstrasse 89b, 8708, Männedorf, Switzerland.
Sci Rep. 2023 Aug 3;13(1):12597. doi: 10.1038/s41598-023-38801-7.
Pseudarthrosis following transforaminal interbody fusion (TLIF) is not infrequent. Although cage migration and subsidence are commonly regarded as evidence of the absence of solid fusion, there is still no evidence of the influence of cage migration and subsidence on fusion. This study aimed to evaluate cage migration and subsidence using computed tomography (CT) DICOM data following lumbar interbody fusion. The effects of cage migration and subsidence on fusion and clinical outcomes were also assessed. A postoperative CT data set of 67 patients treated with monosegmental TLIF was analyzed in terms of cage position. To assess the effects of cage migration and subsidence on fusion, 12-month postoperative CT scans were used to assess fusion status. Clinical evaluation included the visual analog scale for pain and the Oswestry Disability Index. Postoperative cage migration occurred in 85.1% of all patients, and cage subsidence was observed in 58.2%. Radiological signs of pseudarthrosis was observed in 7.5% of the patients Neither cage migration nor subsidence affected the clinical or radiographic outcomes. No correlation was found between clinical and radiographic outcomes. The incidence of cage migration was considerable. However, as cage migration and subsidence were not associated with bony fusion, their clinical significance was considered limited.
经椎间孔腰椎体间融合术（TLIF）后假关节并不少见。虽然 cage 迁移和下沉通常被认为是没有固体融合的证据，但仍然没有证据表明 cage 迁移和下沉对融合有影响。本研究旨在使用腰椎体间融合术后的 CT 数字成像和通信系统（DICOM）数据评估 cage 的迁移和下沉。还评估了 cage 迁移和下沉对融合和临床结果的影响。对 67 例单节段 TLIF 治疗患者的术后 CT 数据集进行了 cage 位置分析。为了评估 cage 迁移和下沉对融合的影响，使用术后 12 个月的 CT 扫描评估融合状态。临床评估包括疼痛视觉模拟评分和 Oswestry 残疾指数。所有患者中有 85.1%发生了术后 cage 迁移，58.2%发生了 cage 下沉。7.5%的患者出现了影像学假关节的迹象。 cage 迁移和下沉均不影响临床和影像学结果。临床和影像学结果之间没有相关性。 cage 迁移的发生率相当高。然而，由于 cage 迁移和下沉与骨融合无关，因此认为其临床意义有限。
