What question did this study set out to answer?

This research aims to develop a classification system to enhance surgical treatment selection for cage retropulsion in degenerative lumbar disease.

February 19, 2026BMC Musculoskeletal Disorders0 citationsOpen Access

Revision surgical treatments and classification system for cage retropulsion in degenerative lumbar disease

WZWeiming ZhaoSichuan University LWLei WangHebei Medical University YSYawen SuSichuan University

Key Points

This research aims to develop a classification system to enhance surgical treatment selection for cage retropulsion in degenerative lumbar disease.
Developed a classification system for surgical approach selection based on severity of retropulsion.
Analyzed the outcomes of anterior surgery for L5-above segments with mild retropulsion.
Evaluated posterior surgery recommendations for L5/S1 segments with severe retropulsion.
Considered timing of revision surgery and migration grade in planning interventions.
Early revision surgery may improve outcomes for symptomatic cases.
Anterior lumbar interbody fusion (ALIF) is effective for low-grade retropulsion at L5/S1 when performed by experienced surgeons.
Surgical success is influenced by tailored strategies based on individual cases.

Abstract

This study proposes a practical classification system with preliminary feasibility in surgical approach selection for cage retropulsion. For symptomatic cases, early revision may yield better outcomes. Anterior surgery is recommended for L5-above segments with mild retropulsion, and posterior surgery is suggested for L5/S1 with severe retropulsion. In addition, anterior lumbar interbody fusion (ALIF) is a good option for L5/S1 with low-grade retropulsion when performed by experienced surgeon. Surgical success depends on tailored strategies considering revision timing, segments, and migration grade. But additional data are needed to confirm long-term safety and inform optimal management.

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