Relationship between anterior convex angle and fusion cage settlement after oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation

doi:10.12307/2025.170

Abstract

Abstract: BACKGROUND: With the continuous advancement of medical technology, the combination of oblique lumbar interbody fusion and percutaneous pedicle screw fixation has become a common method for treating lumbar degenerative diseases; however, there is still a lack of in-depth research on the relationship between changes in anterior convexity angles at different postoperative segments and fusion device settlement.
OBJECTIVE: To explore the relationship between changes in anterior convexity angle of different segments and Cage subsidence after oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation surgery.
METHODS: Patients (93 cases) with lumbar degenerative diseases who underwent oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation surgery in Weifang Hospital of Traditional Chinese Medicine from February 2019 to April 2023 were selected as the research subjects. According to the postoperative disc height loss value, they were divided into Cage subsidence group (25 cases, ≥ 2 mm) and non-Cage subsidence group (68 cases, < 2 mm). Multiple Logistic regression analysis was used to analyze the risk factors for cage subsidence. Stepwise regression was utilized to evaluate the relationship of each risk factor and Cage subsidence. Risk prediction model was built and evaluated.
RESULTS AND CONCLUSION: (1) After adjusting for confounding factors, there was still independent correlation between lumbar lordosis loss value and segmental lordosis improvement value and Cage subsidence risk (P < 0.05). (2) Age, oswestry disability index, disc height improvement value, segmental lordosis improvement value, and lumbar lordosis loss value were all independent influencing factors for the occurrence of Cage subsidence (P < 0.05). Among them, age, lumbar lordosis loss value, disc height improvement value, and segmental lordosis improvement value were most closely related to Cage subsidence. (3) The results of multivariate Logistic regression model analysis showed that when P=0.80, the Jordan index was the highest and the prediction effect was the best, with accuracy of 89.27%, sensitivity of 86.67%, and specificity of 89.89%. The model evaluation results showed that it had good discrimination and high accuracy. (4) As the lumbar lordosis loss value and segmental lordosis improvement value increase, the risk of Cage subsidence increases, which affects clinical efficacy. (5) It is indicated that age, lumbar lordosis loss value, disc height improvement value, and segmental lordosis improvement value are most closely related to Cage subsidence, and clinical doctors should pay more attention.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: umbar degenerative disease, oblique lumbar interbody fusion, percutaneous pedicle screw fixation, lumbar lordosis, Cage subsidence

CLC Number:

Zhou Youzhi, Gao Peng, Yuan Qingsen, Tan Ying, Xu Shitao, Chen Guanglin, Wang Jinqiang, Zhang Liang. Relationship between anterior convex angle and fusion cage settlement after oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(15): 3171-3178.

Figures/Tables 9

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