背景:笼子下沉是腰椎椎间融合术后常见的并发症,低骨密度(BMD)是一个重要的危险因素。从临床MRI扫描获得的终板骨质量(EBQ)被认为是确定区域BMD的可靠方法。然而,EBQ评分与斜向腰椎椎间融合术(OLIF)后的笼沉降之间的关联尚未明确.
目的:本研究旨在评估接受单水平OLIF的患者EBQ评分与笼沉降之间的关系。
方法:回顾性研究。
方法:该研究包括患有退行性脊柱疾病的成年人,他们在我们机构接受了单级OLIF,圆盘高度,EBQ得分,融合率。
方法:这项回顾性研究分析了2017年10月至2022年8月在我们机构接受单级别OLIF手术的患者的数据。术后CT扫描用于测量笼子下沉,而EBQ评分是使用术前非对比T1加权MRI计算的。为了确定EBQ分数的预测能力,受试者工作特征(ROC)曲线分析。此外,进行了单变量和多变量逻辑回归分析。
结果:在这项研究中,共纳入88例患者,平均随访15.8个月.观察到32.9%(n=29/88)的患者经历了笼子下沉。与没有发生下沉的患者相比,发生下沉的患者术后椎间盘高度明显更高。无沉降和沉降患者的平均EBQ评分分别为2.31±0.6和3.48±1.2,这种差异具有统计学意义。ROC曲线分析显示EBQ评分的AUC为0.811(95%CI:0.717-0.905)。EBQ评分的最合适阈值确定为2.318(灵敏度:93.1%,特异性:55.9%)。此外,多因素logistic回归分析显示,EBQ评分越高,沉降风险越高(比值比[OR]=6.204,95%CI=2.520~15.272,p<.001).
结论:我们的研究结果表明,较高的术前EBQ评分与单水平OLIF后的笼子下沉有显著关联。MRI的术前测量可以作为预测笼沉降的有价值的工具。
BACKGROUND: Cage subsidence is a common complication after lumbar interbody fusion surgery, with low bone mineral density (BMD) being a significant risk factor.
Endplate bone quality (EBQ) obtained from clinical MRI scans has been deemed reliable in determining regional BMD. However, the association between EBQ score and cage subsidence following oblique lumbar interbody fusion (OLIF) has not been clearly established.
OBJECTIVE: This study aims to assess the relationship between EBQ score and cage subsidence in patients who underwent single-level OLIF.
METHODS: A retrospective study.
METHODS: The study included adults with degenerative spinal conditions who underwent single-level OLIF at our institution.
METHODS: Cage subsidence, disc height, EBQ score, fusion rate.
METHODS: This retrospective study analyzed data from patients who underwent single-level OLIF surgery at our institution between October 2017 and August 2022. Postoperative CT scans were used to measure cage subsidence, while the EBQ score was calculated using preoperative non-contrast T1-weighted MRI. To determine the predictive ability of the EBQ score, receiver operating characteristic (ROC) curve analysis was conducted. Additionally, univariable and multivariable logistic regression analyses were performed.
RESULTS: In this study, a total of 88 patients were included and followed up for an average of 15.8 months. It was observed that 32.9% (n=29/88) of the patients experienced cage subsidence. The post-surgery disc height was significantly higher in patients who experienced subsidence compared to those who did not. The mean EBQ scores for patients with non-subsidence and subsidence were 2.31±0.6 and 3.48±1.2, respectively, and this difference was statistically significant. The ROC curve analysis showed that the AUC for the EBQ score was 0.811 (95% CI: 0.717-0.905). The most suitable threshold for the EBQ score was determined to be 2.318 (sensitivity: 93.1%, specificity: 55.9%). Additionally, the multivariate logistic regression analysis revealed a significant association between a higher EBQ score and an increased risk of subsidence (odds ratio [OR]=6.204, 95% CI=2.520-15.272, p<.001).
CONCLUSIONS: Our findings indicate that higher preoperative EBQ scores are significantly linked to cage subsidence following single-level OLIF. Preoperative measurement of MRI can serve as a valuable tool in predicting cage subsidence.