Korean J Spine Search


Subsidence after Anterior Lumbar Interbody Fusion using Stand-alone Cages
Jae Young Choi, M.D. and Kyeong Hoon Sung, M.D.
Department of Neurosurgery, 21st Century Hospital, Seoul, Korea
단독 Cage를 이용한 전방 요추체간 골유합술 후의 Subsidence
21세기 병원 신경외과
The authors conducted a study to determine at what stage after surgery the subsidence occurred, to assess the relationships of radiographic fusion and recurrence of symptom with the development of subsidence.
Ninety patients who underwent a single level ALIF were evaluated radiologically and clinically. The ratio of male to female patients was 1:3.1, with a mean age of 53 years, ranging from 25 to 72. The mean follow-up duration was 27 months (range 19 to 38 months). The preoperative and postoperative disc heights were measured with plain radiographs. The location of subsidence and times until the presence of subsidence were also assessed.
The disc height revealed a marked loss after initial distraction. Seventy-one of 90 patients(78.9%) developed subsi- dence. Subsidence was more often noted in the superior endplate. The 12- and 16-week actuarial rates for subsidence were 65.6%, and 72.2%, respectively(Kaplan-Meier's method). The log-rank test could find no statistical correlation with radiographic fusion(p=0.9806). However, there was a significant correlation between recurrence of symptom and the loss of disc height in the chi-square test(p=0.004).
Cage subsidence was an expected occurrence after ALIF, but patients had a significant correlation with recurrence of symptom in proportion as the loss of disc height increases in this study. The 3-month actuarial rate for developing cage subsidence was 65.6%.
Keywords: Anterior lumbar interbody fusion(ALIF)ㆍCageㆍSubsidence

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