Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures
Introduction: This study aims to investigate risk factors for cage subsidence following minimally invasive lateral corpectomy for osteoporotic vertebral fractures. Methods: Eight males and 13 females (77.2±6.0 years old) with osteoporotic vertebral fractures who underwent single corpectomy using a w...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japanese Society for Spine Surgery and Related Research
2023-07-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/7/4/7_2022-0215/_pdf/-char/en |
| _version_ | 1797659781874319360 |
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| author | Shuhei Iwata Toshiaki Kotani Tsuyoshi Sakuma Yasushi Iijima Shun Okuwaki Shuhei Ohyama Satoshi Maki Yawara Eguchi Sumihisa Orita Kazuhide Inage Yasuhiro Shiga Masahiro Inoue Tsutomu Akazawa Shohei Minami Seiji Ohtori |
| author_facet | Shuhei Iwata Toshiaki Kotani Tsuyoshi Sakuma Yasushi Iijima Shun Okuwaki Shuhei Ohyama Satoshi Maki Yawara Eguchi Sumihisa Orita Kazuhide Inage Yasuhiro Shiga Masahiro Inoue Tsutomu Akazawa Shohei Minami Seiji Ohtori |
| author_sort | Shuhei Iwata |
| collection | DOAJ |
| description | Introduction: This study aims to investigate risk factors for cage subsidence following minimally invasive lateral corpectomy for osteoporotic vertebral fractures.
Methods: Eight males and 13 females (77.2±6.0 years old) with osteoporotic vertebral fractures who underwent single corpectomy using a wide-footprint expandable cage with at least a 1-year follow-up were retrospectively included. The endplate cage (EC) angle was defined as the angle between the vertebral body's endplate and the cage's base on the cranial and caudal sides. A sagittal computed tomography scan was performed immediately after surgery and at the final follow-up, with cage subsidence defined as subsidence of 2 mm on the cranial or caudal side. Risk factors were analyzed by dividing cases into groups with (n=6) and without (n=15) cage subsidence.
Results: No significant differences were noted in age, bone mineral density, number of fixed vertebrae, sagittal parameters, preoperative and final kyphosis angle, amount of kyphosis angle correction, bone union, screw loosening, and number of other vertebral fractures preoperatively and 1-year postoperatively between the two groups. No difference was noted in cranial EC angle, but a significant difference was noted in caudal EC angle in the group with (10.7±4.1°) and without (4.7±4.2°) subsidence (P=0.008). Logistic regression analysis with the dependent variable as presence or absence of subsidence showed that caudal EC angle (>7.5°) was a significant factor (odds ratio: 20, 95% confidence interval: 1.655-241.7, P=0.018).
Conclusions: In minimally invasive lateral corpectomy for osteoporotic vertebral fractures, a cage tilted more than 7.5° to the caudal vertebral endplate is a risk factor for cage subsidence. The cage should be placed as perpendicular to the endplate as possible, especially to the caudal vertebral body, to avoid cage subsidence. |
| first_indexed | 2024-03-11T18:20:09Z |
| format | Article |
| id | doaj.art-75571501d45d43009e66d1f3bdd79300 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-03-11T18:20:09Z |
| publishDate | 2023-07-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-75571501d45d43009e66d1f3bdd793002023-10-16T00:32:24ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2023-07-017435636210.22603/ssrr.2022-02152022-0215Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral FracturesShuhei Iwata0Toshiaki Kotani1Tsuyoshi Sakuma2Yasushi Iijima3Shun Okuwaki4Shuhei Ohyama5Satoshi Maki6Yawara Eguchi7Sumihisa Orita8Kazuhide Inage9Yasuhiro Shiga10Masahiro Inoue11Tsutomu Akazawa12Shohei Minami13Seiji Ohtori14Department of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, St. Marianna University School of MedicineDepartment of Orthopedic Surgery, Seirei Sakura Citizen HospitalDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityIntroduction: This study aims to investigate risk factors for cage subsidence following minimally invasive lateral corpectomy for osteoporotic vertebral fractures. Methods: Eight males and 13 females (77.2±6.0 years old) with osteoporotic vertebral fractures who underwent single corpectomy using a wide-footprint expandable cage with at least a 1-year follow-up were retrospectively included. The endplate cage (EC) angle was defined as the angle between the vertebral body's endplate and the cage's base on the cranial and caudal sides. A sagittal computed tomography scan was performed immediately after surgery and at the final follow-up, with cage subsidence defined as subsidence of 2 mm on the cranial or caudal side. Risk factors were analyzed by dividing cases into groups with (n=6) and without (n=15) cage subsidence. Results: No significant differences were noted in age, bone mineral density, number of fixed vertebrae, sagittal parameters, preoperative and final kyphosis angle, amount of kyphosis angle correction, bone union, screw loosening, and number of other vertebral fractures preoperatively and 1-year postoperatively between the two groups. No difference was noted in cranial EC angle, but a significant difference was noted in caudal EC angle in the group with (10.7±4.1°) and without (4.7±4.2°) subsidence (P=0.008). Logistic regression analysis with the dependent variable as presence or absence of subsidence showed that caudal EC angle (>7.5°) was a significant factor (odds ratio: 20, 95% confidence interval: 1.655-241.7, P=0.018). Conclusions: In minimally invasive lateral corpectomy for osteoporotic vertebral fractures, a cage tilted more than 7.5° to the caudal vertebral endplate is a risk factor for cage subsidence. The cage should be placed as perpendicular to the endplate as possible, especially to the caudal vertebral body, to avoid cage subsidence.https://www.jstage.jst.go.jp/article/ssrr/7/4/7_2022-0215/_pdf/-char/enminimally invasive lateral corpectomyosteoporotic vertebral fracturescage subsidence |
| spellingShingle | Shuhei Iwata Toshiaki Kotani Tsuyoshi Sakuma Yasushi Iijima Shun Okuwaki Shuhei Ohyama Satoshi Maki Yawara Eguchi Sumihisa Orita Kazuhide Inage Yasuhiro Shiga Masahiro Inoue Tsutomu Akazawa Shohei Minami Seiji Ohtori Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures Spine Surgery and Related Research minimally invasive lateral corpectomy osteoporotic vertebral fractures cage subsidence |
| title | Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures |
| title_full | Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures |
| title_fullStr | Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures |
| title_full_unstemmed | Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures |
| title_short | Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures |
| title_sort | risk factors for cage subsidence in minimally invasive lateral corpectomy for osteoporotic vertebral fractures |
| topic | minimally invasive lateral corpectomy osteoporotic vertebral fractures cage subsidence |
| url | https://www.jstage.jst.go.jp/article/ssrr/7/4/7_2022-0215/_pdf/-char/en |
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