biostudies-literatureHu XNational Natural Science Foundation of ChinaNational Key Research and Development Program of China49https://www.ebi.ac.uk/biostudies/studies/S-EPMC12849482biostudies-literatureUnknown21(1)<h4>Purpose</h4>To investigate the correlation between postoperative bone cement distribution patterns and the incidence of cage subsidence in elderly osteoporotic patients undergoing oblique lateral interbody fusion combined with anterolateral fixation and stress endplate augmentation (OLIF-AF-SEA).<h4>Methods</h4>This retrospective study analyzed 86 osteoporotic patients aged ≥ 60 years who underwent single-level L4-5 OLIF-AF-SEA with a minimum postoperative follow-up of 24 months. Postoperative X-rays were used to classify bone cement distribution patterns, including coronal plane distribution (three-zone method), endplate contact (binary classification), and presence of intervertebral leakage. Cage subsidence was defined as a reduction in disc height of ≥ 2 mm. Statistical analyses incJournal of orthopaedic surgery and researchBone cement distribution patterns influence cage subsidence after OLIF-AF-SEA in elderly patients with osteoporotic lumbar degeneration.PMC12849482823724392023YFC3604404, 2023YFC3604405Peng XXie THu XZeng JPu XWang XLuo CfalseBone cement distribution patterns influence cage subsidence after OLIF-AF-SEA in elderly patients with osteoporotic lumbar degeneration.<h4>Purpose</h4>To investigate the correlation between postoperative bone cement distribution patterns and the incidence of cage subsidence in elderly osteoporotic patients undergoing oblique lateral interbody fusion combined with anterolateral fixation and stress endplate augmentation (OLIF-AF-SEA).<h4>Methods</h4>This retrospective study analyzed 86 osteoporotic patients aged ≥ 60 years who underwent single-level L4-5 OLIF-AF-SEA with a minimum postoperative follow-up of 24 months. Postoperative X-rays were used to classify bone cement distribution patterns, including coronal plane distribution (three-zone method), endplate contact (binary classification), and presence of intervertebral leakage. Cage subsidence was defined as a reduction in disc height of ≥ 2 mm. Statistical analyses inc2025-01-01T00:00:00Z2025 Dec2026-06-16T07:18:48.624Z2026-06-16T03:09:42.233ZS-EPMC128494824144456810.1186/s13018-025-06576-4