A major complication of lateral lumbar interbody fusion (LLIF) is cage subsidence, which may lead to clinical problems, including loss of disc height correction, altered spinal alignment, recurrent pain, and vertebral body fracture.

A thorough review of the current knowledge about the risk factors for the two types of cage subsidence after LLIF—intraoperative endplate injury and late-onset cage subsidence—could bring attention to well-established risk factors for clinical consideration while identifying any incompletely characterized factors that require further research to clarify.

We performed a systematic review to answer the following questions: (1) Are bone quality and surrogates for bone quality, such as patient age and sex, associated with an increased likelihood of cage subsidence? (2) Are implant-related factors associated with an increased likelihood of cage subsidence?