{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:35:21Z","timestamp":1782311721270,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007824","name":"Soochow University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007824","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>In the treatment of lumbar degenerative spondylolisthesis (LDS) with Posterior lumbar interbody fusion (PLIF) surgery, interbody fusion implants play a key role in supporting the vertebral body and facilitating fusion. The objective of this study was to assess the impact of implantation depth on sagittal parameters and functional outcomes in patients undergoing PLIF surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study reviewed 128 patients with L4\u2010L5 LDS between January 2016 and August 2019. All patients underwent an open PLIF surgery that included intravertebral decompression, implantation of pedicle screws and cage. We grouped according to the position of the center of the cage relative to the L5 vertebral endplate. Patients with the center of the cage located at the anterior 1\/2 of the upper end plate of the L5 vertebral body were divided into Anterior group, and located at the posterior 1\/2 of the upper end plate of the L5 vertebral body were divided into Posterior group. The lumbar lordosis (LL), segmental lordosis (SL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and slope degree (SD) was measured for radiographic outcomes. We used the visual analog scale (VAS) and the oswestry disability index (ODI) score to assess functional outcomes. Paired <jats:italic>t<\/jats:italic>\u2010test was used to compare imaging and bedside data before and after surgery between the two groups, and independent sample <jats:italic>t<\/jats:italic>\u2010test, \u03c7<jats:sup>2<\/jats:sup> test and Fisher exact test were used to compare the data between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>The mean follow\u2010up of Anterior group was 44.13\u2009\u00b1\u20099.23\u2009months, and Posterior group was 45.62\u2009\u00b1\u200910.29\u2009months (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). The LL, SL, PT, SS, SD and PI\u2010LL after operation showed great improvements, relative to the corresponding preoperative values in both groups (<jats:italic>P<\/jats:italic> &lt;\u20090.05). Compared to Posterior group, Anterior group exhibited far enhanced SL (15.49\u2009\u00b1\u20093.28 <jats:italic>vs.<\/jats:italic> 13.67\u2009\u00b1\u20092.53, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), LL (53.47\u2009\u00b1\u20093.21 vs. 52.08\u2009\u00b1\u20093.15, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) outcomes and showed depressed PI\u2010LL (8.87\u2009\u00b1\u20095.05 vs. 10.73\u2009\u00b1\u20095.39, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) outcomes at the final follow\u2010up. Meanwhile, the SL in Anterior group (16.18\u2009\u00b1\u20093.99) 1\u2009months after operation were also higher than in Posterior group (14.12\u2009\u00b1\u20093.57) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). We found that VAS and ODI at the final follow\u2010up in Anterior group (3.62\u2009\u00b1\u20090.96, 25.19\u2009\u00b1\u20095.25) were significantly lower than those in Posterior group (4.12\u2009\u00b1\u20090.98, 27.68\u2009\u00b1 5.13) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For patients with LDS, the anteriorly placed cage may provide better improvement of SL after PLIF surgery. Meanwhile, the anteriorly placed cage may achieve better sagittal parameters of LL and PI\u2010LL and functional outcomes at the final follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14071","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T04:43:49Z","timestamp":1713847429000},"page":"1327-1335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Cage Implantation Depth on Sagittal Parameters and Functional Outcomes in Posterior Lumbar Interbody Fusion for the Treatment of <scp>L4\u2010L5<\/scp> Lumbar Degenerative Spondylolisthesis"],"prefix":"10.1111","volume":"16","author":[{"given":"Lei","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanning","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Changshu Hospital affiliated to Nanjing University of Chinese Medicine  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2639-5103","authenticated-orcid":false,"given":"Zhonglai","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-3475","authenticated-orcid":false,"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04736-1"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198503000-00003"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001109"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.2.FOCUS18722"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.02.019"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200103010-00023"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2516-6"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000462077.50830.1a"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-023-01947-2"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.04.167"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13224"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000343544.77456.46"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1757-7861.2011.00165.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.9.SPINE16232"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2009.1.4.207"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-017-5170-z"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1757-7861.2012.00175.x"},{"key":"e_1_2_12_19_1","first-page":"551","article-title":"Global sagittal alignment and clinical outcomes after 1\u20103 short\u2010segment lumbar fusion in degenerative spinal diseases. 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