title: Intraoperative loosening of Bagby and Kuslich cages during anterior lumbar interbody fusion.
abstract: The Bagby and Kuslich (BAK) interbody fusion system has been shown to be a safe and effective method for obtaining solid fusion while maintaining lumbar lordosis. Although postoperative cage loosening has been reported, intraoperative cage loosening has not. The authors describe three cases in which BAK cages became loosened during operation. After the first BAK cage was inserted, it appeared to be well positioned and firmly seated; after placement of the second cage, however, the first cage was loose. Each of these cages was replaced without incident and appeared well placed on follow-up. It is crucial for the surgeon to verify that all cages are firmly seated before closure. This may reduce the incidence of postoperative cage migration.
authors.affiliation: Center for Sports Medicine and Orthopaedics, Foundation for Research, Chattanooga, Tennessee 37404, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Hodges
authors.forename: S C
authors.initials: SC
authors.lastname: Humphreys
authors.forename: J C
authors.initials: JC
authors.lastname: Eck
authors.forename: R B
authors.initials: RB
authors.lastname: Murphy
mesh_terms: D001696:Biomechanical Phenomena; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000209:etiology* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D019736:Prostheses and Implants / Q000009:adverse effects*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods