Abstract
We investigated the incidence and clinical features of cage subsidence after single-level lateral lumbar interbody fusion (LLIF). We studied a retrospective cohort of 59 patients (34 males, 25 females; mean age, 68.9 years) who received single-level LLIF. Patients were classified into subsidence and no-subsidence groups. Cage subsidence was defined as any violation of either endplate, classified using radiographs and computed tomography (CT) images. After one year, we compared patient characteristics, surgical parameters, radiological findings, pain scores, and fusion status. We also compared the Hounsfield unit (HU) endplate value obtained on CT preoperatively. Twenty patients (33.9%) had radiographic evidence of interbody cage subsidence. There were significant differences between the subsidence and no-subsidence groups in sex, cage height, fusion rate, and average HU value of both endplates (p < 0.05). There were no significant differences in age, height, weight, or body mass index. Moreover, there were no significant differences in global alignment and Numerical Rating Scale change in low back pain, leg pain, and numbness. Despite suggestions that patients with lower HU values might develop cage subsidence, our results showed that cage subsidence after single-level LLIF was not associated with low back pain, leg pain, or numbness one year post-operation.
Highlights
Received: 24 January 2022Lateral lumbar interbody fusion (LLIF) via the lateral retroperitoneal approach has gained popularity and has been widely adopted to achieve interbody fusion with fewer complications [1–3]
(15.3%), delayed cage subsidence (DCS) was observed in 11 patients (18.6%), and total postoperative cage subsidence was identified in 20 patients (33.9%) one year postoperatively
We examined the cage subsidence at a single level of lateral lumbar interbody fusion (LLIF) in this study
Summary
Lateral lumbar interbody fusion (LLIF) via the lateral retroperitoneal approach has gained popularity and has been widely adopted to achieve interbody fusion with fewer complications [1–3]. It can be performed by two approaches, (1) extreme lateral interbody fusion [4], which accesses the intervertebral disc via transpsoas, and (2) oblique Lateral. The. LLIF provides the ability to release, reconstruct and fuse the spine while simultaneously providing indirect decompression of the neural elements through disc space distraction and spinal alignment. LLIF provides the ability to release, reconstruct and fuse the spine while simultaneously providing indirect decompression of the neural elements through disc space distraction and spinal alignment This approach usually does not encounter great abdominal vessels. As with other minimally invasive approaches, the postoperative pain and the return to activities of daily living are faster [6–8]
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