Effect of soft tissue thickness over the posterior border of the vertebral body and disc space on cage placement during posterior lumbar interbody fusion

A cadaveric study

Jae Hyuk Yang, Niraj Sharad Kasat, Jin Ho Whang, Min Keun Kim, Kyueng Whan Min, Jae-Young Hong, Hitesh N. Modi, Seung-Woo Suh

Research output: Contribution to journalArticle

Abstract

In the present study, we investigated whether there is a difference between visual depth (VD) and radiological image depth (RD) of cages (i.e., structural interbody support devices) placed in disc spaces during posterior lumbar interbody fusion and whether soft tissues covering the posterior border of the vertebral body and associated disc space are the cause of any observed differences. Using digital calipers, cages were inserted at a depth of 5 mm from the soft tissues covering the posterior border of the vertebral body and disc space under direct vision; this depth was defined as VD. After insertion, RD was measured in triplicate. The reliability of RD measurements was evaluated using an intraclass coefficient test. To identify the cause of differences between VD and RD, the thicknesses of soft tissues were measured microscopically. A total of 40 lumbar intervertebral disc spaces with cages were evaluated. The mean RD of cages was 3.12 mm, while the mean difference between the VD and RD of cages (DVRD) was 1.91 mm. On histological examination, the mean thickness of the soft tissue was 2.02 mm. Comparative analysis between histological values and DVRD showed no statistical difference (P = 1.14, 1.55, 0.06). There was a significant difference between VD and RD during cage placement, and soft tissue structure appeared to be responsible for the DVRD of inserted cages. Therefore, cages should be inserted deeper to account for differences between visual and radiological image depths. Clin. Anat. 25:1066-1073, 2012. © 2012 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)1066-1073
Number of pages8
JournalClinical Anatomy
Volume25
Issue number8
DOIs
Publication statusPublished - 2012 Nov 1

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Intervertebral Disc
Equipment and Supplies

Keywords

  • cage
  • posterior interbody fusion
  • soft tissue structures
  • spine
  • vertebral body

ASJC Scopus subject areas

  • Anatomy
  • Histology

Cite this

Effect of soft tissue thickness over the posterior border of the vertebral body and disc space on cage placement during posterior lumbar interbody fusion : A cadaveric study. / Yang, Jae Hyuk; Kasat, Niraj Sharad; Whang, Jin Ho; Kim, Min Keun; Min, Kyueng Whan; Hong, Jae-Young; Modi, Hitesh N.; Suh, Seung-Woo.

In: Clinical Anatomy, Vol. 25, No. 8, 01.11.2012, p. 1066-1073.

Research output: Contribution to journalArticle

Yang, Jae Hyuk ; Kasat, Niraj Sharad ; Whang, Jin Ho ; Kim, Min Keun ; Min, Kyueng Whan ; Hong, Jae-Young ; Modi, Hitesh N. ; Suh, Seung-Woo. / Effect of soft tissue thickness over the posterior border of the vertebral body and disc space on cage placement during posterior lumbar interbody fusion : A cadaveric study. In: Clinical Anatomy. 2012 ; Vol. 25, No. 8. pp. 1066-1073.
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