BACKGROUND CONTEXT

Cage subsidence following transforaminal lumbar interbody fusion (TLIF) has been associated with poor bone quality. Current evidence suggests that the magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score correlates with poor bone quality.

PURPOSE

To our knowledge, this is the first study to assess whether the VBQ score can predict the occurrence of postoperative cage subsidence after TLIF surgery.

DESIGN/SETTING

Retrospective single-center cohort.

PATIENT SAMPLE

Patients undergoing single-level TLIF for degenerative spine disease between February 2014 and October 2021.

OUTCOME MEASURES

Extent of subsidence.

METHODS

Demographic, procedure-related, and radiographic data were collected for study patients. VBQ scores were determined from preoperative T1-weighted MRI. Subsidence was defined as ≥2 mm of migration of the cage into the superior or inferior end plate or both. Univariate and multivariate logistic regression were used to determine the correlation between potential risk factors for subsidence and actual subsidence rates.

RESULTS

Subsidence was observed among 42 of the 74 study patients. The mean VBQ scores were 2.9±0.5 for patients with subsidence and 2.5±0.5 for patients without subsidence. The difference among groups was significant (p=.003). On multivariate logistic regression, a higher VBQ score was significantly associated with an increased risk of subsidence (OR=1.5, 95% CI=1.160–1.973, p=.004) and was the only significant independent predictor of subsidence after TLIF.

CONCLUSION

We found that a higher VBQ score was significantly associated with cage subsidence following TLIF. The MRI-VBQ score may be a valuable tool for assisting in identifying patients at risk of cage subsidence following TLIF.

中文翻译：

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椎骨质量评分独立预测经椎间孔腰椎椎间融合术后融合器下沉

背景背景

经椎间孔腰椎椎间融合术 (TLIF) 后的融合器下沉与骨质量差有关。目前的证据表明，基于磁共振成像 (MRI) 的椎体骨质量 (VBQ) 评分与骨质量差相关。

目的

据我们所知，这是第一个评估 VBQ 评分是否可以预测 TLIF 手术后术后笼下沉发生情况的研究。

设计/设置

回顾性单中心队列。

患者样本

2014 年 2 月至 2021 年 10 月期间因退行性脊柱疾病接受单水平 TLIF 的患者。

结果衡量标准

下沉的程度。

方法

收集研究患者的人口统计学、手术相关数据和放射学数据。VBQ 评分由术前 T1 加权 MRI 确定。沉降定义为融合器迁移到上端板或下端板或两者中≥2mm。使用单变量和多变量逻辑回归来确定沉降的潜在危险因素与实际沉降率之间的相关性。

结果

74 名研究患者中有 42 名观察到下陷。有下陷的患者的平均VBQ评分为2.9±0.5，无下陷的患者的平均VBQ评分为2.5±0.5。组间差异显着 (p=.003)。在多变量逻辑回归中，较高的 VBQ 评分与沉降风险增加显着相关（OR=1.5，95% CI=1.160–1.973，p=.004），并且是 TLIF 后沉降的唯一显着独立预测因子。

结论

我们发现较高的 VBQ 评分与 TLIF 后笼子下沉显着相关。MRI-VBQ 评分可能是一个有价值的工具，可帮助识别 TLIF 后有笼子下沉风险的患者。