Abstract
Transforaminal lumbar interbody fusion (TLIF) is a widely accepted surgical procedure, but cage migration (CM) and cage retropulsion (CR) are associated with poor outcomes. This study seeks to identify risk factors associated with these serious events. A prospective observational longitudinal study. Over a 5-year period, 881 lumbar levels in 784 patients were treated using TLIF at three spinal surgery centers. We evaluated the odds ratio of the risk factors for CM with and without subsidence and CR in multivariate analysis. Our study classified CM into two subgroups: CM without subsidence and CM with subsidence. Cases of spinal canal and/or foramen intrusion of the cage was defined separately as CR. Patient records, operative notes, and radiographs were analyzed for factors potentially related to CM with subsidence, CM without subsidence, and CR. Of 881 lumbar levels treated with TLIFs, CM without subsidence was observed in 20 (2.3%) and CM with subsidence was observed in 36 (4.1%) patients. Among the CM cases, CR was observed in 17 (17/56, 30.4%). The risk factors of CM without subsidence were osteoporosis (OR 8.73, p < .001) and use of a unilateral single cage (OR 3.57, p < .001). Osteoporosis (OR 5.77, p < .001) and endplate...Continue Reading
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