ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024
Endplate weakening during cage bed preparation significantly reduces endplate load capacity.
Article in 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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparing the predictive value of CT-derived hounsfield units and MRI-derived bone quality scores for cage subsidence following spinal fusion: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Ex vivo mechanical evaluation of anatomically and mechanically conforming patient-specific lumbar spinal fusion cages designed by full-scale topology optimization.North American Spine Society journal · 2026Article
- Endplate Bone Quality Assessment for Preoperative Planning and Patient-Specific Implementation in Lumbar Spine Surgery.Journal of clinical medicine · 2026Article
- Strategic Use of the 30-Degree Endoscope in Biportal Endoscopic Lumbar Interbody Fusion for Spondylolisthesis With Severe Disc Height Loss: A Technique Note and Case Series.International journal of spine surgery · 2026Article
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- Comparison of midterm outcomes between biportal endoscopic transforaminal lumbar interbody fusion and oblique lumbar interbody fusion with lateral vertebral body screw fixation for single level spondylolisthesis.BMC musculoskeletal disorders · 2025Article
- Risk Factors and Consequences of Cage Subsidence after Single-level Posterior or Transforaminal Lumbar Interbody Fusion: A Retrospective Multicenter Study.Spine surgery and related research · 2025Article
- Is the size of the transforaminal lumbar cage a risk factor for cage subsidence? a retrospective cohort study.Neurosurgical review · 2025Article
- Augmenting Screw Technique to Prevent TLIF Cage Subsidence: A Biomechanical In Vitro Study.Bioengineering (Basel, Switzerland) · 2025Article
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Authors and funding
6 authors.
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Abstract
purposeTo analyze the effect of endplate weakness prior to PLIF or TLIF cage implantation and compare it to the opposite intact endplate of the same vertebral body. In addition, the influence of bone quality on endplate resistance was investigated.
methodsTwenty-two human lumbar vertebrae were tested in a ramp-to-failure test. One endplate of each vertebral body was tested intact and the other after weakening with a rasp (over an area of 200 mm
resultsWith an intact endplate and a TLIF cage, the median force to failure was 1276.3N (693.1-1980.6N). Endplate weakening reduced axial endplate resistance to failure by 15% (0-23%). With an intact endplate and a PLIF cage, the median force to failure was 1057.2N (701.2-1735.5N). Endplate weakening reduced axial endplate resistance to failure by 36.6% (7-47.9%). Bone quality correlated linearly with the force at which endplate failure occurred. Intact and weakened endplates showed a strong positive correlation: intact-TLIF: r = 0.964, slope of the regression line (slope) = 11.8, p < 0.001; intact-PLIF: r = 0.909, slope = 11.2, p = 5.5E-05; weakened-TLIF: r = 0.973, slope = 12.5, p < 0.001; weakened-PLIF: r = 0.836, slope = 6, p = 0.003.
conclusionWeakening of the endplate during cage bed preparation significantly reduces the resistance of the endplate to subsidence to failure: endplate load capacity is reduced by 15% with TLIF and 37% with PLIF. Bone quality correlates with the force at which endplate failure occurs.
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