Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery
Study DesignA retrospective clinical case series.PurposeTo determine the strength of association between cage retropulsion and its related factors.Overview of LiteratureLumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignmen...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2018-02-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-12-59.pdf |
| _version_ | 1819145979790622720 |
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| author | Dong-Yeong Lee Young-Jin Park Sang-Youn Song Soon-Taek Jeong Dong-Hee Kim |
| author_facet | Dong-Yeong Lee Young-Jin Park Sang-Youn Song Soon-Taek Jeong Dong-Hee Kim |
| author_sort | Dong-Yeong Lee |
| collection | DOAJ |
| description | Study DesignA retrospective clinical case series.PurposeTo determine the strength of association between cage retropulsion and its related factors.Overview of LiteratureLumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging.MethodsFrom January 2006 to June 2016, 1,047 patients with lumbar degenerative disc disease who underwent posterior lumbar interbody fusion or transforaminal interbody fusion at Gyeongsang National University Hospital were enrolled. Medical records and pre- and postoperative radiographs were reviewed to identify significant cage retropulsion-related factors. The associations between cage retropulsion with various risk factors were evaluated by calculating odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis.ResultsOf 1,229 disc levels, 16 cases (1.3%, 10 men and 6 women) had cage retropulsion. Univariate analysis revealed no significant differences between the cage retropulsion group and the no cage retropulsion group with regard to demographic data such as age, sex, weight, height, body mass index (BMI), smoking habits, presence of osteoporosis, and duration of follow-up. Multivariate analysis revealed that low BMI (OR, 0.875; 95% CI, 0.771–0.994; p=0.040), presence of screw loosening (OR, 27.400; 95% CI, 7.818–96.033; p<0.001), and pear-shaped disc (OR, 9.158; 95% CI, 2.455–34.160; p=0.001) were significantly associated with cage retropulsion.ConclusionsThis study demonstrated that low BMI, loosening of posterior instrumentation, and pear-shaped disc were associated with cage retropulsion after lumbar interbody fusion. Therefore, when performing lumbar interbody fusion with a cage, surgeons should have skillful surgical techniques for firm fixation to prevent cage retropulsion, particularly in non-obese patients. |
| first_indexed | 2024-12-22T13:06:38Z |
| format | Article |
| id | doaj.art-26db95020da04446b1e8988be1e02a69 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-22T13:06:38Z |
| publishDate | 2018-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-26db95020da04446b1e8988be1e02a692022-12-21T18:24:51ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462018-02-01121596810.4184/asj.2018.12.1.59368Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion SurgeryDong-Yeong Lee0Young-Jin Park1Sang-Youn Song2Soon-Taek Jeong3Dong-Hee Kim4Department of Orthopaedic Surgery, The Armed Forces Daegu Hospital, Gyeongsan, Korea.Department of Orthopaedic Surgery, Research Institute of Clinical Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.Department of Orthopaedic Surgery, Research Institute of Clinical Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.Department of Orthopaedic Surgery, Research Institute of Clinical Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.Department of Orthopaedic Surgery, Research Institute of Clinical Medicine, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.Study DesignA retrospective clinical case series.PurposeTo determine the strength of association between cage retropulsion and its related factors.Overview of LiteratureLumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging.MethodsFrom January 2006 to June 2016, 1,047 patients with lumbar degenerative disc disease who underwent posterior lumbar interbody fusion or transforaminal interbody fusion at Gyeongsang National University Hospital were enrolled. Medical records and pre- and postoperative radiographs were reviewed to identify significant cage retropulsion-related factors. The associations between cage retropulsion with various risk factors were evaluated by calculating odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis.ResultsOf 1,229 disc levels, 16 cases (1.3%, 10 men and 6 women) had cage retropulsion. Univariate analysis revealed no significant differences between the cage retropulsion group and the no cage retropulsion group with regard to demographic data such as age, sex, weight, height, body mass index (BMI), smoking habits, presence of osteoporosis, and duration of follow-up. Multivariate analysis revealed that low BMI (OR, 0.875; 95% CI, 0.771–0.994; p=0.040), presence of screw loosening (OR, 27.400; 95% CI, 7.818–96.033; p<0.001), and pear-shaped disc (OR, 9.158; 95% CI, 2.455–34.160; p=0.001) were significantly associated with cage retropulsion.ConclusionsThis study demonstrated that low BMI, loosening of posterior instrumentation, and pear-shaped disc were associated with cage retropulsion after lumbar interbody fusion. Therefore, when performing lumbar interbody fusion with a cage, surgeons should have skillful surgical techniques for firm fixation to prevent cage retropulsion, particularly in non-obese patients.http://www.asianspinejournal.org/upload/pdf/asj-12-59.pdfSpineLumbar vertebraeSpinal fusionComplications |
| spellingShingle | Dong-Yeong Lee Young-Jin Park Sang-Youn Song Soon-Taek Jeong Dong-Hee Kim Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery Asian Spine Journal Spine Lumbar vertebrae Spinal fusion Complications |
| title | Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery |
| title_full | Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery |
| title_fullStr | Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery |
| title_full_unstemmed | Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery |
| title_short | Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery |
| title_sort | risk factors for posterior cage migration after lumbar interbody fusion surgery |
| topic | Spine Lumbar vertebrae Spinal fusion Complications |
| url | http://www.asianspinejournal.org/upload/pdf/asj-12-59.pdf |
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