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• W2894857785 abstract "BACKGROUND CONTEXT Postoperative subsidence of the transforaminal lumbar interbody fusion (TLIF) cages can result in loss of lordosis and foraminal height, and in some cases recurrence of nerve root impingement and radicular symptoms. PURPOSE The purpose of this study is to determine factors associated with TLIF cage subsidence. Specifically, we sought to determine if preoperative disc height compared to cage height could be used to predict TLIF interbody cage subsidence. STUDY DESIGN/SETTING Retrospective case-control study. PATIENT SAMPLE We identified 127 patients with complete imaging who met our inclusion criteria, with a mean clinical follow up of 27 months. OUTCOME MEASURES The primary outcome of this study was presence of cage subsidence identified with radiograph or CT. METHODS We retrospectively reviewed all patients undergoing instrumented TLIF from two institutions between July 2004 and June 2014. Postoperative imaging studies (radiographs and CT) were evaluated for evidence of implant subsidence. Preoperative disc height was measured for the operative and adjacent level disc heights. The delta between cage height and disc heights were measured and compared between groups. RESULTS Fifty four patients (44.3%) had evidence of interbody cage subsidence. Average cage subsidence was 5.5mm, with a range of 2.2–10.8mm. We found implant height was significantly higher in the subsidence group (12.6mm) when compared to the nonsubsidence group (11.2mm). Additionally, the delta between cage height and preoperative disc height was significantly larger in the subsidence group delta (5.5mm vs. 3.9mm). Similarly, the delta between cage height and preoperative adjacent level disc height was also significantly larger (1.2mm vs. 3.8mm). CONCLUSIONS This study demonstrates that preoperative disc height and preoperative adjacent level disc height can be used to template TLIF cage height to potentially decrease rates of subsidence. Larger cages subsided more frequently than smaller cages. Patients with evidence of subsidence had larger deltas between cage height and preoperative disc height. Similarly, a significant difference existed if preoperative adjacent level disc height was compared to cage height. This demonstrates that preoperative imaging should be used for TLIF cage height templating to avoid subsidence." @default.
• W2894857785 created "2018-10-12" @default.
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• W2894857785 date "2018-08-01" @default.
• W2894857785 modified "2023-09-23" @default.
• W2894857785 title "Friday, September 28, 2018 1:00 PM–2:30 PM abstracts: achieving lumbar interbody fusion" @default.
• W2894857785 doi "https://doi.org/10.1016/j.spinee.2018.06.461" @default.
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