Related Experiment Video
Updated: Jul 23, 2026
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Risk Factors for Cage Subsidence After Transforaminal Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis
Fangshan Bi1, Wenxue Chen1, Jie Yu2
1Department of Spine and Joint, Beijing Fengsheng Special Hospital of Traditional Medical Traumatology and Orthopedics.
Study Design:
A systematic review and meta-analysis.
Background Summary:
Cage subsidence (CS) is a common complication following transforaminal lumbar interbody fusion (TLIF) surgery.
Objective:
This study aimed to identify and analyze risk factors associated with CS following TLIF.
Methods:
A comprehensive search was conducted across PubMed, Scopus, Embase, and Google Scholar for studies published up to March 31, 2024. Pooled odds ratios (OR), standardized mean differences (SMD), and 95% CI were calculated for each identified risk factor. Interstudy heterogeneity was evaluated using the I ² statistic, and either a random-effects or fixed-effects model was applied as appropriate. Publication bias was assessed through funnel plots.
Results:
Nine studies, comprising data on 1403 patients who had undergone TLIF, were included in the final analysis. Significant risk factors for CS included age (SMD=0.27; 95% CI: 0.12-0.41) and bony endplate injury (OR=7.52; 95% CI: 2.08-27.17). However, no significant associations were found with other potential risk factors, such as cage height, body mass index (BMI), bone mineral density, smoking status, diabetes, sex, center point ratio (CPR), disc height (preprocedure and postprocedure), or surgery location.
Conclusion:
This meta-analysis identified older age and injury to the bony endplate as significant risk factors for CS after TLIF. These findings may help inform clinical decision-making and guide risk stratification in patients considering TLIF.
