Abstract：Objective To investigate the effect of different lumbar intervertebral morphologies on the occurrence of cage subsidence after transforaminal lumbar interbody fusion (TLIF) via a posterior lateral foraminal approach.Methods The clinical and imaging data of 90 patients with degenerative lumbar spine diseases treated with singlesegment TLIF from January 2019 to August 2021 were retrospectively analyzed.Based on the imaging data，the patients were divided into 43 cases in the subsidence group，including 15 men and 28 women with a mean age of (53.56±8.2) years，and 47 cases in the nonsubsidence group，including 8 men and 39 women with a mean age of (58.26±13.53) years.The patients in the two groups were compared in terms of preoperative，postoperative and final followup imaging parameters (intervertebral space height，local anterior convexity angle，endplate morphological parameters，degree of bone redundancy，etc.).The patients were then divided into two groups.There were 46 cases in the group without bone redundancy，of which 15 were male and 31 were female，with a mean age of (50.43±8.76) years，and there were 44 cases in the group with bone redundancy，of which 8 were male and 36 were female，with a mean age of (61.84±11.18) years.The difference in final subsidence was compared between the two groups.Results All patients completed the surgery successfully and were followed up for 12 to 27 months ［(14.5±3.6) months］after surgery.The degree of degeneration of the anterior border of the vertebral body and the morphology of the endplate were higher in the subsidence group than in the nonsubmergence group，and the degree of intervertebral space correction was higher in the subsidence group than in the nonsubmergence group.The degree of bone fragmentation was negatively correlated with the degree of subsidence.The above differences were statistically significant (P＜0.05).Conclusion Patients with irregular endplate morphology and over supported intervertebral space have a higher likelihood of fusion subsidence after TLIF.Bone redundancy at the anterior edge of the vertebral body has positive significance in maintaining local segmental stability and avoiding fusion subsidence after TLIF.
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