2025 Volume 16 Issue 5 Pages 796-802
Introduction: This study investigated the clinical outcomes and bone-related complications of single-level Posterior Lumbar Interbody Fusion (PLIF) in patients with low vertebral Hounsfield Unit (HU) values.
Methods: The study included 99 female patients aged 75 years or older who underwent single-level PLIF and were followed up for at least one year. The mean age was 78 years, with an average follow-up period of 6 years. Patients were divided into two groups using a cutoff value of 100 HU for the mean L2-5 vertebral HU values. We compared background data, surgical data, cage subsidence, bone fusion rates at 1 year and final follow-up, postoperative fragility fractures, revision surgeries due to bone fragility, final JOA scores, and final mobility scores between the groups.
Results: Fifty-two patients were classified into the low HU group. The rates of cage subsidence, bone fusion at 1 year, final bone fusion, postoperative fragility fractures, revision surgeries, final JOA scores, and final mobility scores were 19%, 46%, 83%, 17%, 2%, 22 points, and 3.5 points in the low HU group, compared to 6%, 56%, 88%, 21%, 2%, 22 points, and 3.5 points in the control group, respectively. While the low HU group showed significantly higher rates of cage subsidence, there were no significant differences in other complications or clinical outcomes between the groups.
Conclusions: In single-level PLIF, low vertebral HU values were identified as a risk factor for cage subsidence. However, there were no significant differences in final clinical outcomes or activities of daily living between the groups.
