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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...

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Related Experiment Video

Updated: Jun 23, 2026

Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion
04:42

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Published on: June 16, 2023

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Risk Factors for Subsidence Following Anterior Lumbar Interbody Fusion.

Athan G Zavras1, Vincent Federico1, Michael T Nolte1

  • 1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Global Spine Journal
|May 20, 2022
PubMed
Summary

Anterior lumbar interbody fusion (ALIF) subsidence is predicted by anterior cage placement. This complication, occurring in 22.94% of cases, was linked to increased adjacent segment surgery, highlighting the need for precise surgical technique.

Keywords:
anterior lumbar interbody fusioncage positioncomplicationinterbody cagelumbar spineosteoporosisspine surgerysubsidence

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Area of Science:

  • Spine surgery
  • Orthopedic research
  • Biomechanical analysis

Background:

  • Anterior lumbar interbody fusion (ALIF) is a common spinal procedure.
  • Subsidence, a complication of ALIF, can lead to significant morbidity.
  • Identifying risk factors for subsidence is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify patient and procedural risk factors for subsidence after ALIF.
  • To evaluate the association between subsidence and subsequent adjacent segment surgery.

Main Methods:

  • Retrospective cohort study of 144 patients (170 levels) undergoing ALIF.
  • Patients were categorized into Non-Subsidence (NS-ALIF) and Cage Subsidence (CS-ALIF) groups.
  • Univariate and multivariate analyses assessed demographic, operative, and radiographic predictors.

Main Results:

  • Subsidence occurred in 22.94% of levels.
  • Univariate analysis showed older age, higher BMI, worse ASA, osteoporosis, and anterior cage placement as risk factors.
  • Multivariate analysis identified anterior cage placement as the sole significant predictor (OR: 1.08).
  • Subsidence was associated with a higher rate of adjacent segment surgery.

Conclusions:

  • Anterior cage placement is the primary independent predictor of subsidence in ALIF.
  • Older age, higher BMI, severe ASA, and osteoporosis are contributing factors.
  • Optimizing interbody cage placement and avoiding disc space overstuffing are critical surgical considerations.