{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:17:41Z","timestamp":1781090261351,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2020YFC1107402"],"award-info":[{"award-number":["2020YFC1107402"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81871782"],"award-info":[{"award-number":["81871782"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019539","name":"Science Fund for Distinguished Young Scholars of Tianjin Municipality","doi-asserted-by":"publisher","award":["18JCJQJC47900"],"award-info":[{"award-number":["18JCJQJC47900"]}],"id":[{"id":"10.13039\/501100019539","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Previous studies have shown that bone mineral density (BMD) is a predictor of cage subsidence. Phantom\u2010less quantitative computed tomography (PL\u2010QCT) can measure volumetric bone mineral density (vBMD) of lumbar trabecular and cortical bone. The study of endplate vBMD (EP\u2010vBMD) is important in predicting cage settlement after extreme lateral interbody fusion (XLIF). This study aimed to determine the risk factors for postoperative cage subsidence after XLIF, particularly focusing on the relationship between vBMD measured by automatic PL\u2010QCT and cage subsidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent XLIF surgery from January 2018 to October 2020 with a minimum of 6\u2009months of follow\u2010up were retrospectively included. Cage subsidence was defined as &gt;2\u2009mm cage sinking on the adjacent endplate in follow\u2010up imaging evaluation. Outcome measures were localized vBMDs included EP\u2010vBMDs with different region of interest (ROI) heights measured by PL\u2010QCT based on a customized muscle\u2010fat algorithm. Shapiro\u2013Wilk test, one\u2010way ANOVA, Mann\u2013Whitney test, Fisher exact test, univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were executed in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and thirteen levels of 78 patients were included in the analysis. The mean age was 65\u2009\u00b1\u20097.9\u2009years for 11 males and 67 females. Cage subsidence occurred on 45 (39.8%) surgical levels. There was no significant difference in demographics, fused levels, or preoperative radiographic parameters. 1.25\u2010mm EP\u2010vBMD (0.991 [0.985,0.997], <jats:italic>p<\/jats:italic>\u2009=\u20090.004) and P\u2010TB\u2010vBMD (cage\u2010positioned trabecular volumetric bone mineral density) (0.988 [0.977\u20130.999], <jats:italic>p<\/jats:italic>\u2009=\u20090.026) were cage\u2010subsidence relevant according to univariate analysis. Low 1.25\u2010mm EP\u2010vBMD (0.992 [0.985, 0.999], <jats:italic>p<\/jats:italic>\u2009=\u20090.029) was an independent risk factor according to multifactorial analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative low EP\u2010vBMD was an independent risk factor for postoperative cage subsidence after XLIF. EP\u2010vBMD measured by most cortex\u2010occupied ROI may be the optimal vBMD parameter for cage subsidence prediction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13897","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T07:35:56Z","timestamp":1697700956000},"page":"3126-3135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Cortical Endplate Bone Density Measured by Novel Phantomless Quantitative Computed Tomography May Predict Cage Subsidence more Conveniently and Accurately"],"prefix":"10.1111","volume":"15","author":[{"given":"Mingyuan","family":"Di","sequence":"first","affiliation":[{"name":"Graduate School Tianjin Medical University  Tianjin China"},{"name":"Department of Spine Surgery Tianjin Hospital, Tianjin University  Tianjin 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