Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion
Study DesignRetrospective study.PurposeTo compare intraoperative endplate injury cases and no injury cases in consecutive series and to identify predisposing factors for intraoperative endplate injury.Overview of LiteratureUnintended endplate violation and subsequent cage subsidence is an intraopera...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2016-10-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-10-907.pdf |
| _version_ | 1819075655688519680 |
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| author | Kotaro Satake Tokumi Kanemura Hidetoshi Yamaguchi Naoki Segi Jun Ouchida |
| author_facet | Kotaro Satake Tokumi Kanemura Hidetoshi Yamaguchi Naoki Segi Jun Ouchida |
| author_sort | Kotaro Satake |
| collection | DOAJ |
| description | Study DesignRetrospective study.PurposeTo compare intraoperative endplate injury cases and no injury cases in consecutive series and to identify predisposing factors for intraoperative endplate injury.Overview of LiteratureUnintended endplate violation and subsequent cage subsidence is an intraoperative complication of extreme lateral interbody fusion (XLIF). It is still unknown whether it is derived from inexperienced surgical technique or patients' inherent problems.MethodsConsecutive patients (n=102; mean age, 69.0±0.8 years) underwent XLIF at 201 levels at a single institute. Preoperative and immediately postoperative radiographs were compared and cases with intraoperative endplate injury were identified. Various parameters were reviewed in each patient and compared between the injury and no injury groups.ResultsTwenty one levels (10.4%) had signs of intraoperative endplate injury. The injury group had a significantly higher rate of females (p=0.002), lower bone mineral density (BMD) (p=0.02), higher rate of polyetheretherketone as cage material (p=0.04), and taller cage height (p=0.03) compared with the no injury group. Multivariate analysis indicated that a T-score of BMD as a negative (odds ratio, 0.52; 95% confidence interval, 0.27–0.93; p=0.03) and cage height as a positive (odds ratio, 1.84; 95% confidence interval, 1.01–3.17; p=0.03) were predisposing factors for intraoperative endplate injury.ConclusionsIntraoperative endplate injury is correlated significantly with reduced BMD and taller cage height. Precise evaluation of bone quality and treatment for osteoporosis might be important and care should be taken not to choose excessively taller cage. |
| first_indexed | 2024-12-21T18:28:52Z |
| format | Article |
| id | doaj.art-cfc5c95decea47dbb38ada597e9f94e9 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-21T18:28:52Z |
| publishDate | 2016-10-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-cfc5c95decea47dbb38ada597e9f94e92022-12-21T18:54:21ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462016-10-0110590791410.4184/asj.2016.10.5.907171Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody FusionKotaro Satake0Tokumi Kanemura1Hidetoshi Yamaguchi2Naoki Segi3Jun Ouchida4Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.Study DesignRetrospective study.PurposeTo compare intraoperative endplate injury cases and no injury cases in consecutive series and to identify predisposing factors for intraoperative endplate injury.Overview of LiteratureUnintended endplate violation and subsequent cage subsidence is an intraoperative complication of extreme lateral interbody fusion (XLIF). It is still unknown whether it is derived from inexperienced surgical technique or patients' inherent problems.MethodsConsecutive patients (n=102; mean age, 69.0±0.8 years) underwent XLIF at 201 levels at a single institute. Preoperative and immediately postoperative radiographs were compared and cases with intraoperative endplate injury were identified. Various parameters were reviewed in each patient and compared between the injury and no injury groups.ResultsTwenty one levels (10.4%) had signs of intraoperative endplate injury. The injury group had a significantly higher rate of females (p=0.002), lower bone mineral density (BMD) (p=0.02), higher rate of polyetheretherketone as cage material (p=0.04), and taller cage height (p=0.03) compared with the no injury group. Multivariate analysis indicated that a T-score of BMD as a negative (odds ratio, 0.52; 95% confidence interval, 0.27–0.93; p=0.03) and cage height as a positive (odds ratio, 1.84; 95% confidence interval, 1.01–3.17; p=0.03) were predisposing factors for intraoperative endplate injury.ConclusionsIntraoperative endplate injury is correlated significantly with reduced BMD and taller cage height. Precise evaluation of bone quality and treatment for osteoporosis might be important and care should be taken not to choose excessively taller cage.http://www.asianspinejournal.org/upload/pdf/asj-10-907.pdfBone-implant interfaceMinimally invasive surgical procedureOsteoporosisSpineComplication |
| spellingShingle | Kotaro Satake Tokumi Kanemura Hidetoshi Yamaguchi Naoki Segi Jun Ouchida Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion Asian Spine Journal Bone-implant interface Minimally invasive surgical procedure Osteoporosis Spine Complication |
| title | Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion |
| title_full | Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion |
| title_fullStr | Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion |
| title_full_unstemmed | Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion |
| title_short | Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion |
| title_sort | predisposing factors for intraoperative endplate injury of extreme lateral interbody fusion |
| topic | Bone-implant interface Minimally invasive surgical procedure Osteoporosis Spine Complication |
| url | http://www.asianspinejournal.org/upload/pdf/asj-10-907.pdf |
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