Clin Orthop Surg.  2023 Oct;15(5):809-817. 10.4055/cios23037.

Predictors of Vertebral Endplate Fractures after Oblique Lumbar Interbody Fusion

• Park WT
• Woo IH
• Park SJ
• Lee GW

• KMID: 2546106
• DOI: http://doi.org/10.4055/cios23037

Abstract

Background
Cage subsidence after oblique lumbar interbody fusion (OLIF) induces restenosis and adversely affects patient outcomes. Many studies have investigated the causes of subsidence, one of which is endplate fracture (EF). This study aimed to identify predictors of EF after OLIF.
Methods
This retrospective study reviewed consecutive patients who underwent OLIF at a single institute between August 2019 and February 2022. A total of 104 patients were enrolled. The patients’ demographic data and surgical details were collected through chart reviews. Radiographic variables were measured. Related variables were also analyzed using binomial logistic regression, dividing each group into those with versus without EF.
Results
EF occurred at 30 of 164 levels (18.3%), and the binary logistic analysis revealed that sex (odds ratio [OR], 11.07), inferior endplate concave depth (OR, 1.95), disc wedge angle (OR, 1.22), lumbar lordosis (OR, 1.09), pelvic incidence (OR, 1.07), sagittal vertical axis (OR, 1.02), sacral slope (OR, 0.9), L3–4 level (OR, 0.005), and L4–5 level (OR, 0.004) were significantly related to EF.
Conclusions
OLIF in older Asian patients should be performed carefully after recognizing the high possibility of EF and confirming the factors that should be considered preoperatively.

Keyword

Lumbar; Oblique lumbar interbody fusion; Endplate fracture; Risk factors; Subsidence