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Unsoundness of Aggregate due to Volume Change01:26

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Related Experiment Video

Updated: Aug 4, 2025

Kinematic History of a Salient-recess Junction Explored through a Combined Approach of Field Data and Analog Sandbox Modeling
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Cage subsidence-A multifactorial matter!

Periklis Godolias1, Zachary L Tataryn2, Jonathan Plümer2

  • 1Department of Orthopedics and Trauma Surgery, St. Josef Hospital Essen-Werden, Propsteistraße 2, 45239, Essen, Germany. p.godolias@live.de.

Orthopadie (Heidelberg, Germany)
|April 3, 2023
PubMed
Summary

Cage subsidence is common after thoracolumbar fusion, especially with smaller, expandable posterior cages and in patients with low bone density. These factors significantly impact surgical outcomes.

Keywords:
FusionInterbody deviceLumbarPI-LLPelvic IncidenceSpine surgery

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Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Area of Science:

  • Spine Surgery
  • Orthopedic Research
  • Biomaterials Engineering

Background:

  • Interbody fusion outcomes are limited by cage property variations.
  • Wider cages show promise for improved decompression and reduced subsidence.
  • Optimal cage design for thoracolumbar fusion requires further investigation.

Purpose of the Study:

  • To investigate cage subsidence in thoracolumbar interbody fusion.
  • To compare subsidence rates between lateral and posterior surgical approaches.
  • To identify factors influencing cage subsidence, hypothesizing larger lateral cage surface area reduces subsidence.

Main Methods:

  • Retrospective cohort study of 194 patients undergoing interbody fusion (2016-2019).
  • Analysis of 387 cages across 379 disc levels, focusing on cage subsidence.
  • Evaluation of secondary outcomes including cage dimensions, t-scores, and surgical parameters.

Main Results:

  • Overall subsidence rate of 36.3%; 35.1% for lateral cages and 40.9% for posterior cages.
  • Lower surface area and cage expandability correlated with increased subsidence risk.
  • Osteopenia/osteoporosis (low t-scores) significantly increased subsidence risk (36.8% vs 3.5%).

Conclusions:

  • Cage subsidence is a frequent complication impacting thoracolumbar interbody fusion outcomes.
  • Low t-scores, smaller cage surface area, cage expandability, and posterior cage length are key contributors to subsidence.
  • Understanding these factors is crucial for optimizing surgical techniques and implant selection.