Additional cement augmentation reduces cage subsidence and improves clinical outcomes in oblique lumbar interbody fusion combined with anterolateral screw fixation: A retrospective cohort study

Abstract

PURPOSE: Although OLIF has been well established as a successful surgical treatment for lumbar spondylosis, cage subsidence is one of the troublesome complications. Avoiding risk factors and improving surgical techniques are generally passive ways for cage subsidence prevention. To our knowledge, there has been no active way reported to decrease cage subsidence following OLIF. METHODS: From 2018 to 2021, 63 patients were enrolled and divided into two groups, OLIF group (37 patients) and OLIF with cement augmentation (OLIF-C) group (26 patients). The patients’ characteristics, age, sex, BMI, lesion level, days of hospitalization, visual analogue scale (VAS), surgical data and radiological parameters were recorded and compared. RESULTS: The demographic and surgical data showed no statistical significance between OLIF and OLIF-C groups. OLIF-C group had better pain relief in postoperative 3 months (p = 0.015) and at the last follow-up (p = 0.030), less rate of cage subsidence (p <0.001) with better disc height restoration, segmental lordotic angle maintenance and interbody fusion rate. CONCLUSIONS: Additional cement augmentation for OLIF could minimize the rate of postoperative cage subsidence and the whole procedure was completed through the anterolateral approach without posterior laminectomy and instrumentation, avoiding the damage of posterior back muscle and facet joints.