Risk factors for cage retropulsion following transforaminal lumbar interbody fusion

doi:10.12307/2023.785

Abstract

Abstract: BACKGROUND: Previous literature reported that the fusion cage moved more than 2 mm from its original position, which means that the fusion cage moved backward. At present, clinical observation has found that the factors leading to the displacement of the fusion cage are complex, and the relationship between these factors and the cage retropulsion is not clear.
OBJECTIVE: To explore the risk factors related to cage retropulsion after lumbar interbody fusion.
METHODS: Retrospective analysis was conducted in 200 patients who underwent transforaminal lumbar interbody fusion surgery with a polyetheretherketone interbody fusion from February 2020 to February 2022. According to the distance from the posterior edge of the vertebral fusion cage to the posterior edge of the vertebral body after the operation (the second day after the removal of the drainage tube) and 1, 3, 6 and 12 months after the operation, patients were divided into cage retropulsion group (≥ 2 mm) and cage non-retropulsion group (< 2 mm). The factors that may affect cage retropulsion, such as age, gender, body mass index, bone mineral density, operation time, bleeding, endplate injury, preoperative and postoperative interbody height, cage implantation depth, cage size, and segmental anterior convexity angle, were analyzed by univariate and logistic regression analysis.
RESULTS AND CONCLUSION: (1) Posterior displacement of the fusion cage occurred in 15 cases (15/200). The differences in basic information such as age and body mass index between the two groups were not statistically significant. (2) The results of the univariate analysis were that gap height difference, time to wear a brace, segmental anterior convexity angle difference, bone mineral density, and age were related to posterior migration of the cage. (3) The results of logistic regression analysis were that cage size, endplate injury condition, and depth of cage implantation were risk factors for cage retropulsion. (4) These findings suggest that cage retropulsion after lumbar interbody fusion is caused by multiple factors, including segmental anterior convexity angle difference, bone mineral density, cage size, endplate damage, time to wear a brace, and depth of cage implantation.

Key words: transforaminal lumbar interbody fusion, cage, retropulsion, lumbar vertebra, risk factor

CLC Number:

Xi Jintao, Lu Qilin, Wang Yang, Wang Xiaojuan, Lyu Peng, Chen Long, Shi Zhen, Xie Wei, Zhu Yiliang, Li Xugui. Risk factors for cage retropulsion following transforaminal lumbar interbody fusion[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(9): 1394-1398.

Figures/Tables 6

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