دورية أكاديمية
Cage Obliquity in Oblique Lumbar Interbody Fusion-How Common Is It and What Are the Effects on Fusion Rates, Subsidence, and Sagittal Alignment? A Computed Tomography-Based Analysis.
| العنوان: | Cage Obliquity in Oblique Lumbar Interbody Fusion-How Common Is It and What Are the Effects on Fusion Rates, Subsidence, and Sagittal Alignment? A Computed Tomography-Based Analysis. |
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| المؤلفون: | Foong BCM; Department of Orthopedic Surgery, Tan Tock Seng Hospital, Tan Tock Seng, Singapore., Wong JYH; Department of Orthopedic Surgery, Tan Tock Seng Hospital, Tan Tock Seng, Singapore., Betzler B; Lee Kong Chian School Of Medicine, Nanyang Technological University, Singapore, Singapore., Oh JYL; Department of Orthopedic Surgery, Tan Tock Seng Hospital, Tan Tock Seng, Singapore jacob_oh@yahoo.com. |
| المصدر: | International journal of spine surgery [Int J Spine Surg] 2024 Aug 08. Date of Electronic Publication: 2024 Aug 08. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: International Society for the Advancement of Spine Surgery Country of Publication: Netherlands NLM ID: 101579005 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2211-4599 (Print) Linking ISSN: 22114599 NLM ISO Abbreviation: Int J Spine Surg |
| أسماء مطبوعة: | Publication: 2014- : Aurora, IL : International Society for the Advancement of Spine Surgery Original Publication: [Amsterdam] : Elsevier Inc., c2012- |
| مستخلص: | Background: Oblique lumbar interbody fusion (OLIF) through a prepsoas approach was identified as an alternative to alleviate complications associated with direct lateral interbody fusion. Cage placement is known to influence cage subsidence and fusion rates due to suboptimal biomechanics. There are limited studies exploring cage obliquity as a potential factor influencing fusion outcomes. Hence, our objective was to assess the effects of cage obliquity and position on fusion rates, subsidence, and sagittal alignment in patients who underwent OLIF. Methods: Patients who underwent OLIF for levels L1 to L5 in our center, performed by a single surgeon and with a minimum of 12 months of follow-up, were included in the study. Cage obliquity and sagittal placement were measured, and their correlation with fusion, subsidence, and sagittal alignment correction was assessed. Fusion and subsidence were evaluated using the Bridwell Criteria and Marchi Criteria, respectively. Results: Among the included patients (age, 67.5 ± 7.93 years; 16 men and 37 women), 97 fusion levels were studied. The mean cage obliquity was 4.2° ± 2.8°. Ninety-six levels (99.0%) were considered to have achieved fusion with a Bridwell score of 1 or 2. Eighty-one (83.5%), 14 (14.4%), and 2 (2.06%) operated levels had a Marchi score of 0, 1, and 2, respectively. A Marchi grade of 1 or higher was considered indicative of significant subsidence. There was good improvement in both the segmental lordosis angle (4.2° ± 5.7°; P < 0.0001) and disc height (4.5 ± 3.8 mm; P < 0.0001). Cage placement did not have any statistical correlation with fusion rates, subsidence, or sagittal alignment. Conclusions: Our results indicate that OLIF facilitates appropriate cage placement with only a minor degree of cage obliquity, typically less than 20°. This minor obliquity does not lead to lower fusion rates, increased subsidence, or sagittal malalignment. Despite subsidence being common, the majority of these cases resulted in complete fusion. Competing Interests: Declaration of Conflicting Interests : Each author certifies that neither he or she, nor any member of his or her immediate family, have funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2024 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.) |
| فهرسة مساهمة: | Keywords: fusion; lumbar spine; oblique lumbar interbody fusion; spondylosis; subsidence |
| تواريخ الأحداث: | Date Created: 20240808 Latest Revision: 20240808 |
| رمز التحديث: | 20240809 |
| DOI: | 10.14444/8623 |
| PMID: | 39117459 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2211-4599 |
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| DOI: | 10.14444/8623 |