• J Spinal Disord Tech · Apr 2013

    Subsidence of polyetheretherketone cage after minimally invasive transforaminal lumbar interbody fusion.

    • Moon-Chan Kim, Hung-Tae Chung, Jae-Lim Cho, Dong-Jun Kim, and Nam-Su Chung.
    • Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea.
    • J Spinal Disord Tech. 2013 Apr 1;26(2):87-92.

    Study DesignA retrospective case series.ObjectiveThe aim of this study was to determine the rate of cage subsidence after minimally invasive transforaminal lumbar interbody fusion (MITLIF) conducted using a polyetheretherketone (PEEK) cage, and to identify associated risk factors.Summary Of Background DataAlthough various rates of cage subsidence after lumbar interbody fusion have been reported, few studies have addressed subsidence rate after MITLIF using PEEK cage.MethodsA total of 104 consecutive patients who had undergone MITLIF using a PEEK cage with a minimum follow-up of 2 years were included in this study. Cage subsidence was defined to have occurred when a cage was observed to sink into an adjacent vertebral body by ≥2 mm on the postoperative or serial follow-up lateral radiographs. The demographic variables considered to affect cage subsidence were the following: age, sex, body mass index, bone mineral density, diagnosis, number of fusion segment, and the quality/quantity of back muscle, and the cage-related variables considered were: level of fusion, intervertebral angle, cage size, cage position, and postoperative distraction of disc height. Logistic regression analysis was conducted to explore relations between these variables and cage subsidence.Results: For the 122 cages inserted, the rate of cage subsidence was 14.8% (18 cages), and cage subsidence occurred within 7.2±8.5 (1-25) months of surgery. The odds ratios for factors found to significantly increase the risk of cage subsidence were; 1.950 (95% confidence interval, 1.002-4.224) for L5-S1 level, and 1.018 (95% confidence interval, 1.000-1.066) for anterior cage position.ConclusionsThe rate of PEEK cage subsidence after MITLIF was relatively low. End-plate manipulation and cage insertion during MITLIF were not influenced by a small operation window.

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