====== Cage subsidence ======

Progression of settling with endplate collapse is defined as [[subsidence]].
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Several strategies to improve the surface of contact between an [[interbody device]] and the [[endplate]] have been employed to attenuate the risk of [[cage subsidence]]. 3D-printed patient-specific cages have been presented as a promising alternative to help mitigate that risk, but there is a lack of biomechanical evidence supporting their use. We aim to evaluate the biomechanical performance of 3D printed patient-specific lumbar interbody fusion cages in relation to commercial cages in preventing subsidence.

Methods: A cadaveric model is used to investigate the possible advantage of 3D printed patient-specific cages matching the endplate contour using CT-scan imaging in preventing subsidence in relation to commercially available cages (Medtronic Fuse and Capstone). Peak failure force and stiffness were analyzed outcomes for both comparison groups.

Results: PS cages resulted in significantly higher construct stiffness when compared to both commercial cages tested (>59%). PS cage peak failure force was 64% higher when compared to Fuse cage (P < .001) and 18% higher when compared to Capstone cage (P = .086).

Conclusions: Patient-specific cages required higher compression forces to produce failure and increased the cage-endplate construct' stiffness, decreasing subsidence risk
((Fernandes RJR, Gee A, Kanawati AJ, Siddiqi F, Rasoulinejad P, Zdero R, Bailey CS. Biomechanical Comparison of Subsidence Between Patient-Specific and Non-Patient-Specific Lumbar Interbody Fusion Cages. Global Spine J. 2022 Oct 19:21925682221134913. doi: 10.1177/21925682221134913. Epub ahead of print. PMID: 36259252.)).

===== Cervical Cage Subsidence =====

see [[Cervical Cage Subsidence]].

===== Lumbar Cage Subsidence =====

see [[Lumbar Cage Subsidence]].