Department of Orthopedic Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
Clin Orthop Surg. 2023 Oct;15(5):809-817. doi: 10.4055/cios23037. Epub 2023 Jul 20.
Cage subsidence after oblique lumbar interbody fusion (OLIF) induces restenosis and adversely affects patient outcomes. Many studies have investigated the causes of subsidence, one of which is endplate fracture (EF). This study aimed to identify predictors of EF after OLIF.
This retrospective study reviewed consecutive patients who underwent OLIF at a single institute between August 2019 and February 2022. A total of 104 patients were enrolled. The patients' demographic data and surgical details were collected through chart reviews. Radiographic variables were measured. Related variables were also analyzed using binomial logistic regression, dividing each group into those with versus without EF.
EF occurred at 30 of 164 levels (18.3%), and the binary logistic analysis revealed that sex (odds ratio [OR], 11.07), inferior endplate concave depth (OR, 1.95), disc wedge angle (OR, 1.22), lumbar lordosis (OR, 1.09), pelvic incidence (OR, 1.07), sagittal vertical axis (OR, 1.02), sacral slope (OR, 0.9), L3-4 level (OR, 0.005), and L4-5 level (OR, 0.004) were significantly related to EF.
OLIF in older Asian patients should be performed carefully after recognizing the high possibility of EF and confirming the factors that should be considered preoperatively.
腰椎斜外侧融合术（OLIF）后 cage 沉降会导致再狭窄，并对患者预后产生不利影响。许多研究已经探讨了沉降的原因，其中之一是终板骨折（EF）。本研究旨在确定 OLIF 后 EF 的预测因素。
这是一项回顾性研究，纳入了 2019 年 8 月至 2022 年 2 月期间在一家机构接受 OLIF 的连续患者。共纳入 104 例患者。通过病历回顾收集患者的人口统计学数据和手术细节。测量影像学变量。使用二项逻辑回归分析相关变量，将每组分为存在和不存在 EF 的组。
164 个节段中有 30 个（18.3%）发生 EF，二元逻辑分析显示性别（比值比[OR]，11.07）、下终板凹陷深度（OR，1.95）、椎间盘楔角（OR，1.22）、腰椎前凸（OR，1.09）、骨盆入射角（OR，1.07）、矢状垂直轴（OR，1.02）、骶骨倾斜度（OR，0.9）、L3-4 节段（OR，0.005）和 L4-5 节段（OR，0.004）与 EF 显著相关。
在认识到 EF 发生可能性较高并确认术前应考虑的因素后，对于老年亚洲患者，OLIF 应谨慎进行。
