ArticleOrthopaedic surgery2023
Cortical Endplate Bone Density Measured by Novel Phantomless Quantitative Computed Tomography May Predict Cage Subsidence more Conveniently and Accurately.
Article in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 15 citations in OpenAlex.
- Clinical outcomes and radiologic parameters of percutaneous endoscopic posterior/transforaminal lumbar interbody fusion using rammed-earth technique.Frontiers in surgery · 2026Article
- Heterogeneity in Lumbar Segmental Bone Mineral Density and Age-Related Evolution of Whole-Body Bone Mineral Density: Comprehensive Implications for Osteoporosis Risk Assessment.Orthopaedic surgery · 2026Article
- Adjacent Vertebral BMD Decline After Lateral Lumbar Interbody Fusion.Orthopaedic surgery · 2025Article
- Article
- Effects of lumbar degeneration on the global and regional bone mineral density in osteoporotic patients requiring lumbar interbody fusion for degenerative lumbar diseases.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Quantitative computed tomography provides improved accuracy for diagnosis of lumbar osteoporosis in patients with facet joint osteoarthritis: a cross-sectional study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Subsidence reduction effect of transforaminal lumbar interbody fusion (TLIF) with upper and lower open windows modified with lattice structure.Biomedical engineering letters · 2025Article
- Assessing vertebral bone density changes with phantomless QCT after posterior open reduction and internal fixation.Scientific reports · 2025Article
- Article
- Analysis of guide wire displacement in robot-assisted spinal pedicle screw implantation.Journal of robotic surgery · 2024Article
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14 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivePrevious studies have shown that bone mineral density (BMD) is a predictor of cage subsidence. Phantom-less quantitative computed tomography (PL-QCT) can measure volumetric bone mineral density (vBMD) of lumbar trabecular and cortical bone. The study of endplate vBMD (EP-vBMD) is important in predicting cage settlement after extreme lateral interbody fusion (XLIF). This study aimed to determine the risk factors for postoperative cage subsidence after XLIF, particularly focusing on the relationship between vBMD measured by automatic PL-QCT and cage subsidence.
methodsPatients who underwent XLIF surgery from January 2018 to October 2020 with a minimum of 6 months of follow-up were retrospectively included. Cage subsidence was defined as >2 mm cage sinking on the adjacent endplate in follow-up imaging evaluation. Outcome measures were localized vBMDs included EP-vBMDs with different region of interest (ROI) heights measured by PL-QCT based on a customized muscle-fat algorithm. Shapiro-Wilk test, one-way ANOVA, Mann-Whitney test, Fisher exact test, univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were executed in this study.
resultsOne hundred and thirteen levels of 78 patients were included in the analysis. The mean age was 65 ± 7.9 years for 11 males and 67 females. Cage subsidence occurred on 45 (39.8%) surgical levels. There was no significant difference in demographics, fused levels, or preoperative radiographic parameters. 1.25-mm EP-vBMD (0.991 [0.985,0.997], p = 0.004) and P-TB-vBMD (cage-positioned trabecular volumetric bone mineral density) (0.988 [0.977-0.999], p = 0.026) were cage-subsidence relevant according to univariate analysis. Low 1.25-mm EP-vBMD (0.992 [0.985, 0.999], p = 0.029) was an independent risk factor according to multifactorial analysis.
conclusionPreoperative low EP-vBMD was an independent risk factor for postoperative cage subsidence after XLIF. EP-vBMD measured by most cortex-occupied ROI may be the optimal vBMD parameter for cage subsidence prediction.
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