ArticleTomography (Ann Arbor, Mich.)2026
Quantitative CT-Derived Volumetric Bone Mineral Density Threshold for Predicting Cage Subsidence After Oblique Lumbar Interbody Fusion.
Article in Tomography (Ann Arbor, Mich.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCage subsidence (CS) is among the main complications after oblique lumbar interbody fusion (OLIF) and may lead to the failure of indirect decompression. Accurate preoperative bone quality assessment is critical for risk stratification, yet the optimal imaging modality and diagnostic threshold remain unclear.
objectivesThis study aimed to determine a quantitative computed tomography (QCT)-derived volumetric bone mineral density (vBMD) threshold for predicting CS after OLIF with posterior fixation.
methodsPatients undergoing OLIF with posterior fixation between July 2017 and March 2020 were retrospectively enrolled. Preoperative vBMD was measured using QCT as the average L2-L4 trabecular volumetric BMD. CS was defined as a loss of more than 2 mm of disk height on sagittal midline CT views between 3 days postoperatively and the last follow-up. Clinical and radiographic parameters including gender, age, body mass index, vBMD, number of operative levels, cage dimensions, disk height, segmental lordosis, intraoperative endplate injury, and fusion status were analyzed.
results86 patients (107 operative levels) with a mean follow-up of 20.6 months were included; 25 levels (23.4%) developed CS. Multivariate logistic regression identified vBMD (
conclusionsQCT-derived vBMD provides a phantom-calibrated, protocol-standardized metric for preoperative risk stratification of cage subsidence after OLIF.
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