Evidence map›Paper›PMID 37012487›Full record

ArticleOrthopadie (Heidelberg, Germany)2023

Cage subsidence-A multifactorial matter!

Periklis Godolias, Zachary L Tataryn, Jonathan Plümer, Charlotte Cibura, Yevgeniy Freyvert, Hansjörg Heep, Marcel Dudda, Thomas A Schildhauer, Jens R Chapman, Rod J Oskouian

Abstract read
PubMed Publisher
In one paragraph

Article in Orthopadie (Heidelberg, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Periklis GodoliasDepartment of Orthopedics and Trauma Surgery, St. Josef Hospital Essen-Werden, Propsteistraße 2, 45239, Essen, Germany. p.godolias@live.de.
Zachary L TatarynSeattle Science Foundation, 550 17th Avenue, Suite 600, WA 98122, Seattle, USA.
Jonathan PlümerSeattle Science Foundation, 550 17th Avenue, Suite 600, WA 98122, Seattle, USA.
Charlotte CiburaDepartment of Orthopedics and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
Yevgeniy FreyvertSeattle Science Foundation, 550 17th Avenue, Suite 600, WA 98122, Seattle, USA.
Hansjörg HeepDepartment of Orthopedics and Trauma Surgery, St. Josef Hospital Essen-Werden, Propsteistraße 2, 45239, Essen, Germany.
Marcel DuddaDepartment of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
Thomas A SchildhauerDepartment of Orthopedics and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
Jens R ChapmanSeattle Science Foundation, 550 17th Avenue, Suite 600, WA 98122, Seattle, USA.
Rod J OskouianSeattle Science Foundation, 550 17th Avenue, Suite 600, WA 98122, Seattle, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designRetrospective cohort study

objectiveWider cages are associated with improved decompression and reduced subsidence, but variation in cage physical properties limits consistent outcome analysis after thoracolumbar interbody fusion. This study investigated cage subsidence and its relationship to lateral and posterior approaches with a focus on the hypothesis that the larger surface area of lateral cages results in lower subsidence rates.

methodsThis study retrospectively reviewed 194 patients who underwent interbody fusion between 2016 and 2019 with a primary outcome of cage subsidence. Secondary outcomes were cage distribution (patients, approaches, expandability), cage dimensions, t‑scores, length of hospital stay, blood loss, surgical time, and pelvic incidence-lumbar lordosis (PI-LL) mismatch.

resultsMedical records were reviewed for 194 patients receiving 387 cages at 379 disc levels. Subsidence was identified in 35.1% of lateral cages, 40.9% of posterior cages, and 36.3% of all cages. Lower surface area (p = 0.008) and cage expandability were associated with subsidence risk. Lower anteroposterior cage length proved to be a significant factor in the subsidence of posteriorly placed cages (p = 0.007). Osteopenic and osteoporotic patients experienced cage subsidence 36.8% of the time compared to 3.5% of patients with normal t‑scores (p = 0.001). Cage subsidence correlated with postoperative deterioration of the PI-LL mismatch (p = 0.03). Patients receiving fusion augmentation with bone morphogenic protein experienced higher fusion rates (p < 0.01).

conclusionCage subsidence is a common complication that can significantly impact operative outcomes following thoracolumbar interbody fusion. Low t‑scores, smaller surface area, cage expandability, and lower cage length in posterior approaches contribute significantly to cage subsidence.

Indexed as

LordosisHumansRetrospective StudiesTreatment OutcomeFusionInterbody deviceLumbarPelvic IncidencePI-LLSpine surgery

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.