Letter to the Editor: Risk Factors Affecting Cage Retropulsion into the Spinal Canal Following Posterior Lumbar Interbody Fusion: Association with Diffuse Idiopathic Skeletal Hyperostosis

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Asian Spine J. 2022;16(2):307-308

Publication date (electronic) : 2022 April 25

doi : https://doi.org/10.31616/asj.2022.0089.r1

¹Trauma and Emergency (Orthopaedics), All India Institute of Medical Sciences, Raipur, India

²Postgraduate Institute of Medical Education and Research, Chandigarh, India

Corresponding author: Sanjay Singh Rawat Trauma and Emergency (Orthopaedics), Gate No. 1, Great Eastern Rd, Opposite Gurudwara, All India Institute of Medical Sciences Campus, Tatibandh, Raipur, Chhattisgarh 492099, India Tel: +91-9927444089, Fax: +91-1722756740, E-mail: sanjaymamc07@gmail.com

Received 2022 March 1; Accepted 2022 March 11.

Dear Editor,

We read with great interest the recent study by Kato et al. [1] assessing the risk factors affecting cage retropulsion into the spinal canal following posterior lumbar interbody fusion: association with diffuse idiopathic skeletal hyperostosis. We appreciate the author’s efforts to highlight complications on this crucial topic. However, we wish to put our few queries and want to know the author’s input, so that message from this study is presented with greater clarity.

1. Did the location of cages (anterior/posterior) and undersized/lesser height cages have any effect in your study on cage retropulsion as reported by other authors [2]?
2. Does the rod system used in the study was titanium or polyether ether ketone? What is the author’s recommendation from these two and does it have any effect on outcome [3]?
3. What was the status of interbody fusion after single or double cage, did the number of cages alter the time and quality of fusion, and did the delayed fusion also contribute to delayed retropulsion?
4. Do the authors suggest using a double cage even in poor overall condition patients, as a single cage was associated with more incidences of retropulsion in this study [4]?
5. The same size cage was used in this study at the time of revision surgery. Does the use of a bigger size cage make any difference, as suggested by a few authors [2]?

Notes

No potential conflict of interest relevant to this article was reported.

References

1. Kato S, Terada N, Niwa O, Yamada M. Risk factors affecting cage retropulsion into the spinal canal following posterior lumbar interbody fusion: association with diffuse idiopathic skeletal hyperostosis. Asian Spine J 2021;15:840–8.

2. Hu YH, Niu CC, Hsieh MK, Tsai TT, Chen WJ, Lai PL. Cage positioning as a risk factor for posterior cage migration following transforaminal lumbar interbody fusion: an analysis of 953 cases. BMC Musculoskelet Disord 2019;20:260.

3. Hirt D, Prentice HA, Harris JE, et al. Do PEEK rods for posterior instrumented fusion in the lumbar spine reduce the risk of adjacent segment disease? Int J Spine Surg 2021;15:251–8.

4. Aoki Y, Yamagata M, Nakajima F, Ikeda Y, Takahashi K. Posterior migration of fusion cages in degenerative lumbar disease treated with transforaminal lumbar interbody fusion: a report of three patients. Spine (Phila Pa 1976) 2009;34:E54–8.

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