Zeitschrift fur Orthopadie und Unfallchirurgie最新文献

{"title":"Orthosis in the Treatment of Osteoporosis-associated Fractures and Chronic Symptoms in the Spine - a Systematic Review.","authors":"John Fitzgerald Tipton, Christoph Schulze, Philipp Georg Schnadthorst","doi":"10.1055/a-2566-1049","DOIUrl":"https://doi.org/10.1055/a-2566-1049","url":null,"abstract":"<p><p>Osteoporosis is a systemic skeletal disease of multi-aetiological origin and is a major factor in health economics. The reduction in bone mass and disruption of the microarchitecture lead to an increased risk of fracture. The therapy is versatile, with orthoses being used in the treatment of acute vertebral fractures as well as chronic pain.The aim of this work is to formulate evidence-based recommendations for the use of orthoses in osteoporotic vertebral fractures and chronic symptoms.The literature search was conducted according to the PRISMA protocol at PubMed, ScienceDirect, Cochrane and Google Scholar. The risk of bias of the studies was assessed using RoB2 for randomised studies and ROBINS-I for non-randomised studies. The level of evidence was determined according to AHCPR.A total of 18 studies were identified, with 11 studies focussing on the treatment of chronic back pain in osteoporosis and 7 studies on pain therapy for acute osteoporotic vertebral fractures. The non-RCTs matched 5× to evidence levels IIa. The risk of bias was 10× moderate, 4× severe and 3× critical. The RCTs could be divided by the following evidence levels: 10× Ib, 1× IIb, 1× III and 1× IV. The risk of bias was 10× moderate and 3× critical.In the case of chronic back pain, the use of orthoses leads to a reduction in pain and has a positive effect on back extensor strength, but a significant reduction in pain cannot be achieved in osteoporosis-associated vertebral body fractures. The currently available literature do not support the superiority of a specific type of orthosis.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Shock Wave Therapy (ESWT) as Part of the Treatment of Delayed Healing of Bone Fracture.","authors":"Patrick Vetterling, Frank Bätje, Jörg Schmidt","doi":"10.1055/a-2596-8811","DOIUrl":"https://doi.org/10.1055/a-2596-8811","url":null,"abstract":"<p><p>The following paper provides an overview of the procedure of extracorporeal shockwave therapy and a classification of the current literature. The PubMed, Lvivo and WebOfScience databases were searched for \"Extracorporeal Shockwave Therapy\" and \"Fracture nonunion\". A total of 45 studies were identified, 12 of which were included in the analysis after narrowing them down. Fracture healing rates after the application of extracorporeal shockwave therapy (ESWT) averaged 69.25% (52-86%). Overall, it can be seen that the studies are based on small samples (average 154 patients) with a high variance in sample sizes (17-924 patients).</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Arthroscopic Training and Education Among German-Speaking Surgical Residents: A Prospective Survey from 2020 and 2024.","authors":"Sebastian Schmidt, Natalie Mengis, Luis Navas, Christoph Offerhaus, Julius Watrinet, Daniel Krahl, Sebastian Leutheuser","doi":"10.1055/a-2593-7976","DOIUrl":"https://doi.org/10.1055/a-2593-7976","url":null,"abstract":"<p><p>Arthroscopy has emerged as a crucial technique in modern orthopedic surgery, offering significant advantages over traditional open procedures. However, the steep learning curve and the need for advanced psychomotor skills presents challenges in training residents effectively. This study aimed to assess the development of arthroscopic skills, research involvement, and the impact of the COVID-19 pandemic arthroscopic training among residents in Germany.A prospective cross-sectional survey was conducted among members of the German-speaking Society for Arthroscopy and Joint Surgery (AGA) in two periods: March-April 2020 and March-April 2024. A total of 730 residents were invited to participate with response rates of 38.5% (<i>n</i> = 281) in 2020 and 30.5% (<i>n</i> = 223) in 2024. The survey included questions on demographic data, arthroscopic experience, research activities, participation in cadaver workshops and courses, and subjective perceptions of training.The study revealed significant arthroscopic experience variability (<i>p</i> < 0.001) with no significant differences in independently performed procedures between the 2020 and 2024 cohorts. However, there was a significant association between training year and the number of independently performed arthroscopies (<i>p</i> = 0.002). The COVID-19 pandemic led to a partial shift towards digital learning formats with a reduction in hands-on training opportunities. Despite these challenges, the volume of arthroscopies performed and the amount of research involvement remained stable. The data also indicated a trend towards outsourcing surgical training to external courses and organizations.Despite a subjective worsening of training conditions in the medium term, the volume of arthroscopies, course participation, and research activity of German-speaking residents in orthopedic and trauma surgery remains unchanged, although there is still a substantial variability in arthroscopy case volume. To compensate for this, training is increasingly being outsourced and improved in-house training concepts should be established.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-assessment of Elbow Mobility as a Reliable Method in the Postoperative Follow-up Examination of Radial Head Fractures.","authors":"Johannes Porsche, Patrick Ziegler, Tina Histing, Marc-Daniel Ahrend, Sven Maier, Cornelius Sebastian Fischer","doi":"10.1055/a-2593-9161","DOIUrl":"https://doi.org/10.1055/a-2593-9161","url":null,"abstract":"<p><p>Sufficient follow-up of fractures is often difficult, due to age-related, health-related or geographical reasons. Self-assessment of the patient's functional outcome could be an alternative to a personal medical examination. There is a lack of validated questionnaires to record these parameters for elbow injuries. The aim of the study was to validate the patient's self-assessment of the range of motion following surgical treatment of complex radial head fractures.50 patients (42% women) with a mean age of 49.7 ± 13.8 years (range 25-82 years) with a surgically treated radial head fracture (Mason III or IV) were examined, 39.6 ± 23.3 months postoperatively. The fracture was treated with radial head reconstruction (60%) or radial head prosthesis (40%). The follow-up examination included the assessment of elbow mobility using a questionnaire (Elbow Motion Assessment Score) and physical examination using a goniometer. In addition, quality of life was assessed using the SF-36 Health Survey. The agreement of the mobility was recorded as a percentage using Spearman's correlation.Exact agreement between examiner and patient was achieved at 54% in flexion, 40% in extension, 86% in pronation and 54% in supination. The median deviations in agreement were 10° in extension and flexion and 20° in pronation and supination. The correlations were r = 0.550 (flexion), r = 0.841 (extension), r = 0.808 (pronation) and r = 0.754 (supination). Patients who agreed with the examiner on the movements achieved a higher score in the SF-36 Health Survey than patients who did not agree with the examiner (50.5 to 54.1 vs. 40.0 to 45.5).The survey of the range of motion by the patient using a questionnaire showed a high level of agreement with the measurement by an objective examiner. Such self-assessment can therefore be seen as a suitable, cost-effective alternative in the follow-up examination of surgically treated radial head fractures.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic or Open Excision of Intraarticular Osteoid Osteoma in the Elbow Joint - a Case Report.","authors":"Lisa Hainzer, Markus Reichkendler, Helmut Weitlaner, Stephan Pauly, Christian Gerhardt, Daniel Rau, Kathi Thiele","doi":"10.1055/a-2596-9075","DOIUrl":"https://doi.org/10.1055/a-2596-9075","url":null,"abstract":"<p><p>Pain and stiffness are common symptoms that occur in many elbow pathologies. In the diagnostic algorithm for non-specific elbow pain, benign tumour lesions should be ruled out in rare cases. The following case presentations demonstrate that rare entities such as osteoid osteoma (OO) can be the cause for unclear elbow complaints.Three male patients presented with non-traumatic elbow pain over several months before seeking medical help for the first time. Their main concern was restricted Range of Motion (ROM). The plain radiographs were normal in ⅔ cases, and the CT-scans showed unspecific signs of free joint bodies in the area of the incisura trochlearis of the proximal ulna in the initial stages. Either arthroscopic or open excision was performed as based on CT and/or MRI scans. The decision on the appropriate approach of treatment depends on the localisation of the OO. In particular, the medial ulnohumeral joint section cannot be completely visualised and remains reserved for the open procedure, with the associated disadvantages. Histopathological preparation confirmed the diagnosis. Overall, both techniques seem to reduce the patient's pain immediately, restore ROM with a slight delay, and show almost no recurrence rates of the tumorous lesions.Patients presented with elbow pain and restricted ROM with no history of elbow trauma; plain radiographs as well as nocturnal pain are highly indicative of OO. Even though this is rare, we should always keep it in mind in order to protect the patient from wrong or delayed diagnosis and treatment. A surgical approach is to be preferred, particularly in the case of intra-articular localisation.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Research Gap in Orthopaedics and Trauma Surgery: Gender-specific Disparities in Submission of Abstracts to the German Congress of Orthopaedic and Trauma Surgery from 2015 to 2024.","authors":"Carolina Vogel, Vera Bertsch, Mika F Rollmann, Tina Histing, Benedikt J Braun","doi":"10.1055/a-2561-2910","DOIUrl":"https://doi.org/10.1055/a-2561-2910","url":null,"abstract":"<p><p>Gender-specific differences also affect the subject of orthopaedics and trauma surgery (O&T). While the proportion of women studying medicine is steadily increasing, the proportion of female surgeons in O&T is only 18.6%. This underrepresentation affects not only clinics but also research and is reflected in participation in scientific annual meetings such as the German Congress for Orthopaedics and Trauma Surgery (DKOU).This retrospective study examined the gender differences in abstract submissions to the DKOU from 2015 to 2024. The anonymised data were subjected to examination regarding gender, role in submission and academic title.The overall participation of women in the 82,813 abstracts was 20%. The proportion of women among submitters was 23.3%, among presenters 24.5% and among co-authors 18.2%. In the analysis of the female cohort alone, women were more likely to be submitters and presenters than in the male cohort (p < 0.001). The proportion of female participation in abstract submissions increased by an average of 0.5% per year over the study period. However, women were significantly underrepresented at higher academic degrees, such as habilitations (7.4%), professorships (7.6%) and university professorships (5.2%).The results show that the proportion of women submitting abstracts to the DKOU largely corresponds to the percentage in the field of orthopaedics and trauma surgery (18.6% in 2022), reflecting the overall gender disparity in this specialty. If this trend analysis were applied to the general development of gender parity in orthopaedics and trauma surgery, gender-equitable staffing of medical positions could not be achieved before the year 2087. To accelerate this development, targeted measures to promote women in orthopaedics and trauma surgery are necessary. This includes dismantling structural barriers and implementing specific support programs for female surgeons pursuing academic careers.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plantar Sensation and Muscle Activity During a Step on Various Textured Unstable Surfaces in Patients with Anterior Cruciate Ligament Reconstruction - Comparison with Healthy Controls.","authors":"Martin Alfuth, Nina Plücken, Jonas Klemp, Wilhelm Bloch","doi":"10.1055/a-2577-7304","DOIUrl":"https://doi.org/10.1055/a-2577-7304","url":null,"abstract":"<p><p>After anterior cruciate ligament reconstruction (ACLR), patients have been found to have reduced plantar sensation, which may result in reduced afferent input to the central nervous system and thus contribute to motor deficits. Textured surfaces are thought to have a beneficial neurosensory effect. The aim of this cross-sectional study was to compare plantar sensation and leg muscle activity while stepping on different textured surfaces between patients after ACLR and healthy controls.Plantar cutaneous thresholds to light touch were measured in 10 patients at least 6 months after ACLR and in 10 healthy controls. Patients or controls were asked to step forward on the centre of a force plate with the affected (ACLR) or randomly assigned (healthy controls) leg and maintain the single-legged stance for 10 seconds (floor condition). They were instructed to perform the same task on a balance board with a textured surface, the same balance board with a smooth surface, and a balance pad in random order. Muscle activity of four leg muscles was recorded using surface electromyography. The significance of differences in plantar sensation and mean muscle activity within three time frames between and within ACLR patients and healthy controls was analysed using non-parametric statistical tests with Bonferroni correction (<i>p</i> < 0.05).There were no significant differences between patients with ACLR and healthy controls in plantar sensation and muscle activity for all unstable surface conditions (<i>p</i> > 0.05). Friedman tests revealed significant differences in the activities of all muscles between surface conditions at the first peak of the vertical ground reaction force (vGRF) after the rapid increase in the force-time curve (transition from early lifting phase to late lifting phase) within both groups (<i>p</i> < 0.01). Post-hoc Wilcoxon signed-rank tests showed significantly altered activity for most muscles between the smooth and textured balance board conditions only at the first vGRF peak (<i>p</i> ≤ 0.01) in both patients and healthy controls.Although plantar sensation and muscle activity did not differ between patients with ACLR and healthy controls, altered muscle activity in both groups, especially during the transition from the early to the late lifting phase of stepping on a textured unstable surface, may indicate an acute change in the afferent input of plantar mechanoreceptors in response to the surface stimulus. In addition, it may indicate an acute change in motor output caused by a beneficial neurosensory effect. This effect should be considered with caution due to the small sample size.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life after Multisegmental Fusion Surgery for Degenerative Spine Diseases.","authors":"Frank Beyer, Johanna Schirmer, Tobias Prasse, Peer Eysel, Jan Bredow","doi":"10.1055/a-2546-7316","DOIUrl":"https://doi.org/10.1055/a-2546-7316","url":null,"abstract":"<p><p>Degenerative spinal diseases may lead to multisegmental instabilities and present as de novo scoliosis. Due to frequent primary and secondary complications, their treatment is controversial among spine surgeons. The aim of this systematic review is to investigate the postoperative quality of life after multilevel fusion surgery for de novo scoliosis. Furthermore, technical aspects and complications are examined in detail.A systematic literature search was conducted, excluding systematic reviews or meta-analyses. A follow-up period of at least 24 months was required. Standardised outcome instruments on quality of life, epidemiological data and information on surgical technique and any further follow-up examinations were extracted. Studies on adolescents or neuromuscular scoliosis were excluded, as were case reports and studies on short-span fusions.Twenty studies were included in the systematic review. The Oswestry Disability Index (ODI) was reported in 15 studies. All authors reported significant improvements. Inclusion of the L5/S1 segment showed no differences in quality of life, but better radiological correction, although the rate of adjacent segment degeneration and complications was higher. The data on general postoperative complications ranged from 10.5% to 71.5%.Quality of life after multilevel fusion for de novo scoliosis shows significant improvements. There is no general recommendation on the last instrumented vertebra or the caudal anchoring of the instrumentation. Treatment in specialised centres for spine surgery is strongly recommended, also due to the high postoperative complication rates.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient Hip Synovitis, 146 Cases, Origin and Duration.","authors":"Hartmut Gaulrapp, Philipp Schoof, Gregor Schönecker","doi":"10.1055/a-2533-4972","DOIUrl":"https://doi.org/10.1055/a-2533-4972","url":null,"abstract":"<p><p>Transient hip synovitis is one of the most common paediatric orthopaedic diseases. This non-controlled interventional study investigated the origin, clinical findings, imaging and the duration of symptoms. 146 affected patients out of the total of 27659 patients under 18 years result in an incidence of 0.53%. 76.7% boys outweighed 23.3% girls (1.8-12.9 years [Ø 6.3 y, boys Ø 6.5 y, girls Ø 6.2 y]). Diagnoses were defined by ultrasound and the absence of concurrent diseases. In 60.5% of patients, the right hip was affected, in 39.5% the left. A single patient had CF on both sides but not at the same time. No simultaneous incidence was recorded. There were two singular recurrences. Within the study period, we counted 11 cases of Perthes' disease, 2 juvenile hip arthritis and one septic hip. Patients' history showed 41.0% viral infections, 21.6% physical exertion and 15.1% singular trauma. In 22.3% no origin could be named. Clinical aspects included pain in inward rotation (51.5%), in hip flexion (49.3%) and limping (37.5%). Ultrasound depicted medium joint effusion in 53.4%, marked effusion in 46.6% and synovial thickening in 17.1% of patients. 119 patients could be followed up weekly. Joint effusion vanished after 3-36 days (Ø 13.3 d), clinical symptoms Ø 1.6 days earlier. Total duration in terms of sonographic appearance of effusion was 3 to 37 days (Ø 19.1 d).</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based L1 Vertebral Bone Quality Scores Predict Cage Subsidence Following Transforaminal Lumbar Interbody Fusion Similar to L1 CT Hounsfield Units.","authors":"Yongdi Wang, Qian Chen, Ce Zhu, Youwei Ai, Juehan Wang, Hong Ding, Dun Luo, Limin Liu","doi":"10.1055/a-2550-4502","DOIUrl":"https://doi.org/10.1055/a-2550-4502","url":null,"abstract":"<p><p>Cage subsidence is one of the most common complications after transforaminal lumbar interbody fusion (TLIF) and correlates with inferior bone quality. Studies have reported L1 vertebral bone quality score (VBQ) based on MRI to be a promising alternative to evaluating preoperative bone quality. However, to the knowledge of the authors, no study has examined the correlation between L1 VBQ scores and cage subsidence after TLIF.The purpose of the study was (1) to assess the interrelation between the L1 VBQ score and cage subsidence after TLIF; and (2) to compare L1 VBQ and L1 CT Hounsfield Unit (HU) values in predicting cage subsidence after TLIF.We reviewed patients who had undergone TLIF at one institution between 2012 to 2021. Cage subsidence was measured using postoperative lumbar CT based on cage protrusion through the endplates at more than 2 mm. The L1 VBQ score was calculated by dividing mean L1 signal intensity (SI) by mean SI of the cerebrospinal fluid (CSF) at L1. The L1 HU value representing bone mineral density (BMD) was measured using computed tomography. We then performed Student's <i>t</i>-test for independent samples and logistic regression analyses for statistical analysis. We also conducted receiver operating characteristic (ROC) analysis to assess the predictive ability of the L1 VBQ score and L1 CT HU.Of 233 participants, cage subsidence was observed in 41 patients (17.6%). Comparison between the characteristics of patients between the group with subsidence and the group without subsidence revealed significant differences in the age, VBQ score, and L1 CT HU. Multivariate logistic regression showed that higher L1 VBQ score (OR = 2.499, 95% CI: 1.205-5.180, p = 0.014) and lower L1 CT HU (OR = 0.960, 95% CI: 0.933-0.987, p = 0.005) were associated with an increased rate of cage subsidence. Area under the curve (AUC) analysis of the L1 VBQ score returned 0.735 (95% CI: 0.620-0.850) and the suitable threshold was 3.424 (sensitivity: 82.9%, specificity: 70.7%). The AUC of L1 CT HU was 0.747 (95% CI: 0.642-0.852) and the suitable threshold was 136.5 (sensitivity: 85.4%, specificity: 56.1%).The present study demonstrates that L1 VBQ score and L1 CT HU are reliable predictors with similar performance for cage subsidence after TLIF.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}