ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Sarcopenia as a Predictor for Cage Subsidence following Stand-alone Oblique Lumbar Interbody Fusion in non-osteoporosis patients
Provisionally accepted
- Third Hospital of Hebei Medical University, Shijiazhuang, China
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Objective: This study aimed to identify predictors of cage subsidence following SA-OLIF in non-osteoporosis patients. Methods: A retrospective analysis was performed on 98 patients who underwent SA-OLIF. Cage subsidence was defined as cage subsided into the adjacent endplate by more than 2 mm at the last follow up compared with postoperative radiographs. Patients were categorised into subsidence and non-subsidence groups accordingly. Patient characteristics, radiographic parameters, and clinical outcomes were recorded. Sarcopenia was assessed by measuring the L3 skeletal muscle index (L3-SMI) on axial computed tomography images. Multivariate logistic regression analysis was conducted to identify the predictors of cage subsidence following SA-OLIF. Results: Of the 98 patients who underwent SA-OLIF, subsidence was found in 32 patients (32.7%). The subsidence group had a higher mean age (P = 0.005) and lower bone mineral density (BMD) (P < 0.001). The prevalence of sarcopenia was significantly greater in the subsidence group compared with the non-subsidence group (P = 0.003). Multivariate logistic regression identified sarcopenia (P = 0.021), age (P = 0.011), and BMD (P < 0.001) as predictors of cage subsidence. The areas under the curve (AUCs) for age and BMD in predicting cage subsidence were 0.676 and 0.783, respectively. Conclusion: Cage subsidence following SA-OLIF was a common complication in non-osteoporosis patients and the incidence rate was 32.7%. Preoperative sarcopenia, age > 59.5 and T-score < -1.9 were predictors of cage subsidence following SA-OLIF in non-osteoporosis patients. Patients with sarcopenia had nearly fourfold increased odds of subsidence. OLIF with instruments might be an alternative surgical method for patients with the predictor factors to decrease the incidence of cage subsidence.
Keywords: Bonemineral density, Cage subsidence, predictors, Sarcopenia, Stand-alone oblique interbody fusion
Received: 09 Dec 2025; Accepted: 28 Jan 2026.
Copyright: © 2026 Miao, Gao, Zhang, Ma and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Di Zhang
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