Incidence and risk factors of posterior cage migration following decompression and instrumented fusion for degenerative lumbar disorders

被引:40
作者
Li, Hua [1 ]
Wang, Hui [2 ]
Zhu, Yanbo [3 ]
Ding, Wenyuan [2 ]
Wang, Qian [4 ]
机构
[1] Halison Int Peace Hosp, Dept Spine Surg, Hengshui, Peoples R China
[2] HeBei Med Univ, Hosp 3, Dept Spine Surg, 139 Ziqiang Rd, Shijiazhuang 050051, Hebei, Peoples R China
[3] Hebei Med Univ, Shijiazhuang, Hebei, Peoples R China
[4] HeBei Med Univ, Hosp 3, Financial Stat Dept, Shijiazhuang, Hebei, Peoples R China
关键词
cage migration; degenerative lumbar disorder; spondylolisthesis; ADJACENT SEGMENT DISEASE; PEDICLE SCREW FIXATION; INTERBODY FUSION; RETROPULSION;
D O I
10.1097/MD.0000000000007804
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to explore the incidence and risk factors for posterior cage migration (PCM) following decompression and instrumented fusion for degenerative lumbar disorders, and hope to provide references in decision making and surgical planning for spine surgeons. By retrieving the medical records from January 2011 to December 2015, 286 patients were retrospectively reviewed. According to the occurrence of PCM, patients were divided into 2 groups: PCM group and non-PCM (N-PCM). To investigate risk values for PCM, 3 categorized factors were analyzed statistically: patient characteristics: age, sex, body mass index, bone mineral density, duration of disease, diagnosis, comorbidity, smoke; surgical variables: surgery time, blood loss, surgical strategy, cage morphology, cage size, surgical segment, fusion number, source of bone graft, surgeon experience; radiographic parameters: preoperative lumbar lordosis, correction of lumbar lordosis, preoperative lumbar mobility, preoperative intervertebral height, change of intervertebral height, Modic changes, paraspinal muscle degeneration. PCM was detected in 18 of 286 patients (6.3%) at follow-up. There was no statistically significant difference between the 2 groups in patient characteristics, except diagnosis, as lumbar spondylolisthesis was more prevalent in PCM group than that in N-PCM group. There was no difference between the 2 groups in surgical variables, except cage size and surgeon experience, as size of cage was smaller in PCM group than that in N-PCM group, and the surgeons with less experience (less than 3 years) were more prevalent in PCM group than that in N-PCM group. There was no statistically significant difference between 2 groups in radiographic parameters. Logistic regression model revealed that less than 3 years of surgeons' experience, small cage size, and lumbar spondylolisthesis were independently associated with PCM. For patients with lumbar spondylolisthesis, they should be fully informed about the risk of PCM before operation. While for spinal surgeons, large cage should be preferred, and careful manipulation should be adopted, especially for new learners with less than 3year experience of fusion surgery.
引用
收藏
页数:6
相关论文
共 17 条
[1]   The influence of cage positioning and cage type on cage migration and fusion rates in patients with monosegmental posterior lumbar interbody fusion and posterior fixation [J].
Abbushi, Alexander ;
Cabraja, Mario ;
Thomale, Ulrich-Wilhelm ;
Woiciechowsky, Christian ;
Kroppenstedt, Stefan Nikolaus .
EUROPEAN SPINE JOURNAL, 2009, 18 (11) :1621-1628
[2]   Examining risk factors for posterior migration of fusion cages following transforaminal lumbar interbody fusion: a possible limitation of unilateral pedicle screw fixation Clinical article [J].
Aoki, Yasuchika ;
Yamagata, Masatsune ;
Nakajima, Fumitake ;
Ikeda, Yoshikazu ;
Smmizu, Koh ;
Yoshihara, Masakazu ;
Iwasaki, Junichi ;
Toyone, Tomoaki ;
Nakagawa, Koichi ;
Nakajima, Arata ;
Takahashi, Kazuhisa ;
Ohtori, Seiji .
JOURNAL OF NEUROSURGERY-SPINE, 2010, 13 (03) :381-387
[3]   Posterior Migration of Fusion Cages in Degenerative Lumbar Disease Treated With Transforaminal Lumbar Interbody Fusion A Report of Three Patients [J].
Aoki, Yasuchika ;
Yamagata, Masatsune ;
Nakajima, Fumitake ;
Ikeda, Yoshikazu ;
Takahashi, Kazuhisa .
SPINE, 2009, 34 (01) :E54-E58
[4]   Cage migration in spondylolisthesis treated with posterior lumbar interbody fusion using BAK cages [J].
Chen, L ;
Yang, HL ;
Tang, TS .
SPINE, 2005, 30 (19) :2171-2175
[5]   Complete cage migration/subsidence into the adjacent vertebral body after posterior lumbar interbody fusion [J].
Corniola, Marco V. ;
Jaegersberg, Max ;
Stienen, Martin N. ;
Gautschi, Oliver P. .
JOURNAL OF CLINICAL NEUROSCIENCE, 2015, 22 (03) :597-598
[6]   Clinical outcomes of two types of cages used in transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases: n-HA/PA66 cages versus PEEK cages [J].
Deng, Qian-xing ;
Ou, Yun-sheng ;
Zhu, Yong ;
Zhao, Zeng-hui ;
Liu, Bo ;
Huang, Qiu ;
Du, Xing ;
Jiang, Dian-ming .
JOURNAL OF MATERIALS SCIENCE-MATERIALS IN MEDICINE, 2016, 27 (06)
[7]  
Kim Myung Hoon, 2013, Korean J Spine, V10, P104, DOI 10.14245/kjs.2013.10.2.104
[8]   Risk Factors for Cage Retropulsion After Posterior Lumbar Interbody Fusion Analysis of 1070 Cases [J].
Kimura, Hiroaki ;
Shikata, Jitsuhiko ;
Odate, Seiichi ;
Soeda, Tsunemitsu ;
Yamamura, Satoru .
SPINE, 2012, 37 (13) :1164-1169
[9]   Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion [J].
Lim, TH ;
Kwon, H ;
Jeon, CH ;
Kim, JG ;
Sokolowski, M ;
Natarajan, R ;
An, HS ;
Andersson, GBJ .
SPINE, 2001, 26 (08) :951-956
[10]  
Madera M, 2017, J NEUROSURG-SPINE, V10, P1