Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA.
Neurosurg Rev. 2024 Jul 16;47(1):332. doi: 10.1007/s10143-024-02551-5.
One of the most common complications of lumbar fusions is cage subsidence, which leads to collapse of disc height and reappearance of the presenting symptomology. However, definitions of cage subsidence are inconsistent, leading to a variety of subsidence calculation methodologies and thresholds. To review previously published literature on cage subsidence in order to present the most common methods for calculating and defining subsidence in the anterior lumbar interbody fusion (ALIF), oblique lateral interbody fusion (OLIF), and lateral lumbar interbody fusion (LLIF) approaches. A search was completed in PubMed and Embase with inclusion criteria focused on identifying any study that provided descriptions of the method, imaging modality, or subsidence threshold used to calculate the presence of cage subsidence. A total of 69 articles were included in the final analysis, of which 18 (26.1%) reported on the ALIF approach, 22 (31.9%) on the OLIF approach, and 31 (44.9%) on the LLIF approach, 2 of which reported on more than one approach. ALIF articles most commonly calculated the loss of disc height over time with a subsidence threshold of > 2 mm. Most OLIF articles calculated the total amount of cage migration into the vertebral bodies, with a threshold of > 2 mm. LLIF was the only approach in which most articles applied the same method for calculation, namely, a grading scale for classifying the loss of disc height over time. We recommend future articles adhere to the most common methodologies presented here to ensure accuracy and generalizability in reporting cage subsidence.
腰椎融合术最常见的并发症之一是 cage 沉降，这会导致椎间盘高度的塌陷和原有症状的再次出现。然而，cage 沉降的定义不一致，导致了各种沉降计算方法和阈值的出现。本文旨在回顾既往关于腰椎前路融合术（ALIF）、斜外侧腰椎间融合术（OLIF）和侧路腰椎间融合术（LLIF）中 cage 沉降的文献，介绍最常用于计算和定义这些术式中 cage 沉降的方法。在 PubMed 和 Embase 中进行了检索，纳入标准侧重于确定任何提供 cage 沉降方法、影像学模式或沉降阈值描述的研究。最终分析纳入了 69 篇文章，其中 18 篇（26.1%）报告了 ALIF 方法，22 篇（31.9%）报告了 OLIF 方法，31 篇（44.9%）报告了 LLIF 方法，其中 2 篇报告了超过一种方法。ALIF 文章最常通过沉降阈值 > 2mm 来计算随时间推移的椎间盘高度损失。大多数 OLIF 文章计算 cage 向椎体的整体迁移量，阈值为 > 2mm。LLIF 是唯一一种大多数文章都应用相同计算方法的术式，即用于随时间分类椎间盘高度损失的分级量表。我们建议未来的文章遵循这里提出的最常用方法，以确保 cage 沉降报告的准确性和可推广性。
