Bone cement distribution patterns influence cage subsidence after OLIF-AF-SEA in elderly patients with osteoporotic lumbar degeneration

Postoperative bone cement distribution patterns may influence cage stability following OLIF-AF-SEA. Bilateral distribution, contact with both superior and inferior endplates, and absence of intervertebral leakage are closely associated with reduced risk of subsidence. These findings highlight the importance of standardized cement injection strategies and provide a theoretical foundation for improving surgical outcomes in elderly osteoporotic patients undergoing OLIF-AF-SEA.