J Korean Orthop Assoc.  2019 Jun;54(3):237-243. 10.4055/jkoa.2019.54.3.237.

Analysis of the Risk Factors for Posterior Migration of Single Cage after Transforminal Lumbar Interbody Fusion

• Ko YC
• Ha DJ
• Park MJ
• Huh JW
• Park JH
• Lee WM

• KMID: 2450143
• DOI: http://doi.org/10.4055/jkoa.2019.54.3.237

Abstract

PURPOSE
To analyze the risk factors for posterior migration of a single cage after transforminal lumbar interbody fusion (TLIF).
MATERIALS AND METHODS
This study was conducted retrospectively on 48 patients (60 discs) who were followed-up for 1 year after TLIF from January 2015 to January 2017. The patients were divided into two groups: group 1 containing 16 patients (17 discs) with cage migration and group 2 containing 32 patients (43 discs) without it. Information related to cage migration, such as the demographic factors, shape of disc, level and location of the cage inserted, and disc height change, was acquired from the medical records and radiologic images, and the possibility for generating posterior migration of cage was evaluated statistically.
RESULTS
The demographic factors and cage-inserted level were similar in the two groups (16 patients in group 1, 32 patients in group 2). In the migration group, number of patients with a pear-type disc, 9 patients, was significantly larger; the disc height change, 1.8 mm, was significantly smaller; and the cage was located frequently on non-center in the anteriorposterior view and center in the lateral view in 9 and 15 out of 16 patients, respectively.
CONCLUSION
A pear-type disc shape, small disc height change, cage with non-center on the anteriorposterior view and non-anterior on the lateral view are the risk factors for posterior migration. These factors are important for preventing posterior migration of the cage.

Keyword

transforminal lumbar interbody fusion; single cage; posterior migration; risk factor

MeSH Terms

Demography
Humans
Medical Records
Retrospective Studies
Risk Factors*

Figure

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  Figure 1. Posterior migration of the cage. Postoperation (A), 3 months after operation (B), 6 months after operation (C), 9 months after operation (D), 12 months after operation (E).

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  Figure 2. Pear-shaped disc.

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  Figure 3. Mean disc height. Mean disc height is (a+b)/2. a, anterior disc height; b, posterior disc height.

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  Figure 4. Location of the cage inserted in the disc space. (A) Anterior posterior view. (B) Lateral view. C, center; A, anterior; P, posterior.

Reference

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