{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:31:12Z","timestamp":1787509872538,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3604400"],"award-info":[{"award-number":["2023YFC3604400"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Cage retropulsion (CR) is a common complication following posterior lumbar interbody fusion (PLIF). Symptomatic patients with CR often require revision surgery. However, there is a lack of literature supporting the effectiveness of conservative treatment for CR. This study compares clinical and radiographic outcomes between conservative treatment and revision surgery in patients with CR after PLIF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 55 patients with CR after PLIF treated at our institution between 2016 and 2023 were retrospectively reviewed; postoperative radiographic data of follow\u2010up were used to diagnose CR. Clinical outcomes were assessed before therapy and at the final follow\u2010up using the visual analog scale (VAS) for lower back pain and leg pain, Oswestry Disability Index (ODI) scores, and Japanese Orthopedic Association 29 (JOA\u201029) scores. The treatment effectiveness was evaluated based on whether the score change reached the minimally clinically important difference (MCID). Radiographic indicators included the fusion rates, the extent of CR into the spinal canal, and the total displacement distance. Continuous variables were compared using independent samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests or Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, while categorical variables were analyzed using Chi\u2010square or Fisher's exact tests, as appropriate. A\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt;\u20090.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The fusion rates at the final follow\u2010up for the conservative treatment group and the revision surgery group were 87.5% and 84.6%, respectively. There were no significant differences in final follow\u2010up fusion rates, lower back pain VAS scores, leg pain VAS scores, JOA scores, or ODI scores between the two groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Additionally, there was no difference in the proportion of patients whose lower back pain VAS, ODI, and JOA scores achieved MCID between groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). However, in the revision surgery group, the proportion of patients whose leg VAS scores reached MCID was significantly higher than in the conservative group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). In the revision surgery subgroup analysis, patients who did not achieve leg VAS MCID demonstrated significantly more severe cage retropulsion distance compared to MCID achievers (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Conservative treatment yields satisfactory outcomes in mild, symptomatic CR patients, particularly for low back pain. For patients with a CR distance less than 8.8\u2009mm, conservative treatment and revision surgery showed comparable outcomes, whereas when the CR distance is \u2265\u20098.8\u2009mm, revision surgery was recommended to improve clinical results. Both conservative treatment and revision surgery can yield favorable outcomes when appropriately indicated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70174","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T10:55:51Z","timestamp":1758711351000},"page":"3133-3141","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrospective Analysis of Clinical Management Strategies for Cage Retropulsion Following Posterior Lumbar Interbody Fusion"],"prefix":"10.1111","volume":"17","author":[{"given":"Cheok\u2010Wa","family":"Iao","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weipeng","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuiguo","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woquan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9512-5436","authenticated-orcid":false,"given":"Weishi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","first-page":"2","article-title":"Lumbar Interbody Fusion: Techniques, Indications and Comparison of Interbody Fusion Options Including PLIF, TLIF, MI\u2010TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs R. 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