Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion
Abstract Background For lumbar degenerative diseases, cage subsidence is a serious complication and can result in the failure of indirect decompression in the oblique lumbar interbody fusion (OLIF) procedure. Whether additional lateral plate fixation was effective to improve clinical outcomes and pr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02725-7 |
| _version_ | 1828368570089734144 |
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| author | Tenghui Ge Jintao Ao Guanqing Li Zhao Lang Yuqing Sun |
| author_facet | Tenghui Ge Jintao Ao Guanqing Li Zhao Lang Yuqing Sun |
| author_sort | Tenghui Ge |
| collection | DOAJ |
| description | Abstract Background For lumbar degenerative diseases, cage subsidence is a serious complication and can result in the failure of indirect decompression in the oblique lumbar interbody fusion (OLIF) procedure. Whether additional lateral plate fixation was effective to improve clinical outcomes and prevent cage subsidence was still unknown. This study aimed to compare the incidence and degree of cage subsidence between stand-alone oblique lumbar interbody fusion (SA-OLIF) and OLIF combined with lateral plate fixation (OLIF + LP) for the treatment of lumbar degenerative diseases and to evaluate the effect of the lateral plate fixation. Methods This was a retrospective comparative study. 20 patients with 21 levels underwent SA-OLIF and 21 patients with 26 levels underwent OLIF + LP. We compared clinical and radiographic outcomes between two groups. Clinical evaluation included Visual Analog Scale (VAS) for back pain and leg pain, Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI). Radiographical evaluation included disc height (DH), segmental lordosis angle (SL), and subsidence rate on standing lateral radiographs. Cage subsidence was classified using Marchi’s criteria. Results The mean follow-up duration was 6.3 ± 2.4 months. There were no significant differences among perioperative data (operation time, estimated intraoperative blood loss, and complication), clinical outcome (VAS, ODI, and JOA) and radiological outcome (SH and SL). The subsidence rate was 19.0% (4/21) in SA-OLIF group and 19.2% (5/26) in OLIF + LP group. 81.0% in SA-OLIF group and 80.8% in OLIF + LP group had Grade 0 subsidence, 14.3% in SA-OLIF group and 15.4% in OLIF + LP group had Grade I subsidence, and 4.8% in SA-OLIF group and 3.8% in OLIF + LP group had Grade II subsidence (P = 0.984). One patient with severe cage subsidence and lateral plate migration underwent revision surgery. Conclusions The additional lateral plate fixation does not appear to be more effective to prevent cage subsidence in the oblique lumbar interbody fusion, compared with stand-alone technique. If severe cage subsidence occurs, it may result in lateral plate migration in OLIF combined with lateral plate fixation. |
| first_indexed | 2024-04-14T06:12:46Z |
| format | Article |
| id | doaj.art-028880ca33104b6e94a2864dc9a1e826 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T06:12:46Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-028880ca33104b6e94a2864dc9a1e8262022-12-22T02:08:19ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-10-011611910.1186/s13018-021-02725-7Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusionTenghui Ge0Jintao Ao1Guanqing Li2Zhao Lang3Yuqing Sun4Department of Spine Surgery, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan HospitalDepartment of Spine Surgery, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan HospitalDepartment of Spine Surgery, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan HospitalDepartment of Spine Surgery, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan HospitalDepartment of Spine Surgery, Peking University Fourth School of Clinical Medicine, Beijing Jishuitan HospitalAbstract Background For lumbar degenerative diseases, cage subsidence is a serious complication and can result in the failure of indirect decompression in the oblique lumbar interbody fusion (OLIF) procedure. Whether additional lateral plate fixation was effective to improve clinical outcomes and prevent cage subsidence was still unknown. This study aimed to compare the incidence and degree of cage subsidence between stand-alone oblique lumbar interbody fusion (SA-OLIF) and OLIF combined with lateral plate fixation (OLIF + LP) for the treatment of lumbar degenerative diseases and to evaluate the effect of the lateral plate fixation. Methods This was a retrospective comparative study. 20 patients with 21 levels underwent SA-OLIF and 21 patients with 26 levels underwent OLIF + LP. We compared clinical and radiographic outcomes between two groups. Clinical evaluation included Visual Analog Scale (VAS) for back pain and leg pain, Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI). Radiographical evaluation included disc height (DH), segmental lordosis angle (SL), and subsidence rate on standing lateral radiographs. Cage subsidence was classified using Marchi’s criteria. Results The mean follow-up duration was 6.3 ± 2.4 months. There were no significant differences among perioperative data (operation time, estimated intraoperative blood loss, and complication), clinical outcome (VAS, ODI, and JOA) and radiological outcome (SH and SL). The subsidence rate was 19.0% (4/21) in SA-OLIF group and 19.2% (5/26) in OLIF + LP group. 81.0% in SA-OLIF group and 80.8% in OLIF + LP group had Grade 0 subsidence, 14.3% in SA-OLIF group and 15.4% in OLIF + LP group had Grade I subsidence, and 4.8% in SA-OLIF group and 3.8% in OLIF + LP group had Grade II subsidence (P = 0.984). One patient with severe cage subsidence and lateral plate migration underwent revision surgery. Conclusions The additional lateral plate fixation does not appear to be more effective to prevent cage subsidence in the oblique lumbar interbody fusion, compared with stand-alone technique. If severe cage subsidence occurs, it may result in lateral plate migration in OLIF combined with lateral plate fixation.https://doi.org/10.1186/s13018-021-02725-7Oblique lumbar interbody fusionLumbar degenerative diseaseLateral plate fixationCage subsidenceRevision surgery |
| spellingShingle | Tenghui Ge Jintao Ao Guanqing Li Zhao Lang Yuqing Sun Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion Journal of Orthopaedic Surgery and Research Oblique lumbar interbody fusion Lumbar degenerative disease Lateral plate fixation Cage subsidence Revision surgery |
| title | Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion |
| title_full | Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion |
| title_fullStr | Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion |
| title_full_unstemmed | Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion |
| title_short | Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion |
| title_sort | additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion |
| topic | Oblique lumbar interbody fusion Lumbar degenerative disease Lateral plate fixation Cage subsidence Revision surgery |
| url | https://doi.org/10.1186/s13018-021-02725-7 |
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