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Volume 13
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10.3390/jcm13237036
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Effects of Vacuum Phenomenon on Cage Subsidence and Fusion Outcomes in Oblique Lumbar Interbody Fusion: A Cohort Study

by
Jae-Hyuk Yang
1,
Kun-Joon Lee
2,
Seung-Yup Lee
1,
In-Hee Kim
3,
Sang Yun Seok
4,
Hansongi Suh
5 and
Hyung Rae Lee
1,*
1
Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02708, Republic of Korea
2
College of Medicine, Korea University, Seoul 02841, Republic of Korea
3
National Police Hospital, Seoul 05715, Republic of Korea
4
Department of Orthopedic Surgery, Daejeon Eulji University Hospital, Daejeon 35233, Republic of Korea
5
Department of Business Administration, Yonsei University School of Business, Seoul 03722, Republic of Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(23), 7036; https://doi.org/10.3390/jcm13237036
Submission received: 4 October 2024 / Revised: 5 November 2024 / Accepted: 20 November 2024 / Published: 21 November 2024
(This article belongs to the Special Issue Cutting Edge of Minimally Invasive Spine Surgery)
Versions Notes

Abstract

Background: Oblique lumbar interbody fusion (OLIF) is a minimally invasive technique used to manage degenerative lumbar conditions. The presence of vacuum phenomenon (VP) and associated endplate sclerosis may increase the risk of cage subsidence. This study evaluated the relationship between VP grade, endplate sclerosis, and subsidence in OLIF. Methods: This retrospective cohort study included 165 patients who underwent a single-level OLIF for lumbar stenosis. Patients were stratified into VP grades (0–3) based on preoperative computed tomography scans. Disc height, endplate sclerosis, and cage subsidence were radiologically assessed. Clinical outcomes, including back and leg pain visual analog scale, Oswestry Disability Index, and EuroQol-5 Dimension, were measured preoperatively and at follow-up. Results: High VP grades were associated with low preoperative disc height and increased endplate sclerosis. Although no significant differences in clinical outcomes or final fusion rates across VP grades were observed, the subsidence rate increased with VP grade, with a significant difference between VP grades 1 and 2 (p = 0.045) and between VP grades 2 and 3 (p = 0.032), indicating that subsidence rates increased as the VP grade advanced. Conclusions: High VP grades, particularly grades 2 and 3, may increase the risk of cage subsidence following OLIF. Therefore, VP grading may be worth considering during surgical planning to reduce the subsidence risk and improve outcomes.
Keywords: vacuum phenomenon; cage subsidence; OLIF; lumbar degenerative disease; endplate sclerosis; spine surgery vacuum phenomenon; cage subsidence; OLIF; lumbar degenerative disease; endplate sclerosis; spine surgery

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MDPI and ACS Style

Yang, J.-H.; Lee, K.-J.; Lee, S.-Y.; Kim, I.-H.; Seok, S.Y.; Suh, H.; Lee, H.R. Effects of Vacuum Phenomenon on Cage Subsidence and Fusion Outcomes in Oblique Lumbar Interbody Fusion: A Cohort Study. J. Clin. Med. 2024, 13, 7036. https://doi.org/10.3390/jcm13237036

AMA Style

Yang J-H, Lee K-J, Lee S-Y, Kim I-H, Seok SY, Suh H, Lee HR. Effects of Vacuum Phenomenon on Cage Subsidence and Fusion Outcomes in Oblique Lumbar Interbody Fusion: A Cohort Study. Journal of Clinical Medicine. 2024; 13(23):7036. https://doi.org/10.3390/jcm13237036

Chicago/Turabian Style

Yang, Jae-Hyuk, Kun-Joon Lee, Seung-Yup Lee, In-Hee Kim, Sang Yun Seok, Hansongi Suh, and Hyung Rae Lee. 2024. "Effects of Vacuum Phenomenon on Cage Subsidence and Fusion Outcomes in Oblique Lumbar Interbody Fusion: A Cohort Study" Journal of Clinical Medicine 13, no. 23: 7036. https://doi.org/10.3390/jcm13237036

APA Style

Yang, J. -H., Lee, K. -J., Lee, S. -Y., Kim, I. -H., Seok, S. Y., Suh, H., & Lee, H. R. (2024). Effects of Vacuum Phenomenon on Cage Subsidence and Fusion Outcomes in Oblique Lumbar Interbody Fusion: A Cohort Study. Journal of Clinical Medicine, 13(23), 7036. https://doi.org/10.3390/jcm13237036

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