JORR
Journal of Orthopedics Research and Rehabilitation

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers in orthopaedic surgery, physical therapy and rehabilitation, physiotherapy, neurology and clinic anesthesiology and reanimation.

eISSN: 2980-0560
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Delayed cage retropulsion 15 years after posterior lumbar interbody fusion: a case report
Abstract
Cage retropulsion is a rare complication of lumbar interbody fusion and is typically reported in the early postoperative period. We present a case of delayed symptomatic cage retropulsion occurring 15 years after posterior lumbar interbody fusion (PLIF). The patient presented with progressive low back pain and radicular symptoms. Radiological evaluation demonstrated posterior migration of the intervertebral cage at the operated level. There was no history of early postoperative complications. Delayed retropulsion was considered to be related to long-term biomechanical changes and progressive loss of bone mineral density. This case emphasizes that cage retropulsion may occur many years after PLIF and should be considered in patients with late-onset symptoms following lumbar fusion surgery.

Keywords : Spinal fusion, posterior lumbar interbody fusion, tomography, X-ray computed, retropulsion

Download Article


1. Bingqian C, Feng X, Xiaowen S, et al. Modified posterior lumbar interbody fusion using a single cage with unilateral pedicle screws: a retrospective clinical study. J Orthop Surg Res. 2015;30;10:98. doi:10.1186/s13018-015-0243-3
2. Kim YH, Ha KY, Rhyu KW, et al. Lumbar interbody fusion: techniques, pearls and pitfalls. Asian Spine J. 2020;14(5):730-741. doi:10.31616/asj.2020.0485
3. Lee JG, Lee SM, Kim SW, Shin H. Repeated migration of a fusion cage after posterior lumbar interbody fusion. Korean J Spine. 2013;10(1):25-27. doi:10.14245/kjs.2013.10.1.25
4. Murase S, Oshima Y, Takeshita Y, et al. Anterior cage dislodgement in posterior lumbar interbody fusion: a review of 12 patients. J Neurosurg Spine. 2017;27(1):48-55. doi:10.3171/2016.12.SPINE16429
5. Ariyoshi D, Sano S, Kawamura N. Inferior vena cava injury caused by an anteriorly migrated cage resulting in ligation: case report. J Neurosurg Spine. 2016;24(3):409-412. doi:10.3171/2015.6.SPINE1544
6. Kimura H, Shikata J, Odate S, Soeda T, Yamamura S. Risk factors for cage retropulsion after posterior lumbar interbody fusion: analysis of 1070 cases. Spine (Phila Pa 1976). 2012;37(13):1164-1169. doi:10.1097/BRS.0b013e318257f12a
7. Pan FM, Wang SJ, Yong ZY, Liu XM, Huang YF, Wu DS. Risk factors for cage retropulsion after lumbar interbody fusion surgery: series of cases and literature review. Int J Surg. 2016;30:56-62. doi:10.1016/j.ijsu.2016. 04.025
8. Peng L, Guo J, Lu JP, Jin S, Wang P, Shen HY. Risk factors and scoring system of cage retropulsion after posterior lumbar interbody fusion: a retrospective observational study. Orthop Surg. 2021;13(3):855-862. doi: 10.1111/os.12987
9. Kato S, Terada N, Niwa O, Yamada M. Risk factors affecting cage retropulsion into the spinal canal following posterior lumbar interbody fusion: association with diffuse idiopathic skeletal hyperostosis. Asian Spine J. 2021;15(6):840-848. doi:10.31616/asj.2020.0434
10. Lee DY, Park YJ, Song SY, Jeong ST, Kim DH. Risk factors for posterior cage migration after lumbar interbody fusion surgery. Asian Spine J. 2018;12(1):59-68. doi:10.4184/asj.2018.12.1.59
11. Zhang M, Liu X, Wang G, Liu H, Zhu F, Mou H. Risk factors associated with cage retropulsion after lumbar interbody fusion. Turk Neurosurg. 2024;34(2):274-282. doi:10.5137/1019-5149.JTN.43124-23.2
12. Liu Y, Chen H, Hu X, et al. Risk factors influencing cage retropulsion following lumbar interbody fusion in treating degenerative lumbar diseases: a comprehensive systematic review and meta-analysis. J Orthop Sci. 2025;30(5):768-779. doi:10.1016/j.jos.2025.01.001
13. Liu K, Chang H, Wang L, Wang C, Chen T, Meng X. Risk factors for cage retropulsion after lumbar interbody fusion: systematic review and meta-analysis. World Neurosurg. 2019;132:273-281. doi:10.1016/j.wneu. 2019.09.019
14. Grant JP, Oxland TR, Dvorak MF. Mapping the structural properties of the lumbosacral vertebral endplates. Spine (Phila Pa 1976). 2001;26(8): 889-896.
Article available in :
Volume 4, Issue 2, 2026
Page : 44-46
https://doi.org/10.51271/JORR-0070
Article Information
Received : 23 Şub 2026
Accepted : 30 Nis 2026
Published : 30 Nis 2026
Corresponding Author :

HAKAN AK: Department of Neurosurgery, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkiye

[email protected]
Citation : Ak H, Özgül S, Avgın E. Delayed cage retropulsion 15 years after posterior lumbar interbody fusion: a case report. J Orthop Res Rehabil. 2026;4(2):44-46.

Read: 41
Download : 32
Cited: 0
_Footer