Chul Gie Hong, Woo Dong Nam, Young Ju Lee, Dong-Ho Lee
{"title":"Effect of Osteoporosis on Clinical and Radiological Outcomes Following One-Level Anterior Cervical Discectomy and Fusion.","authors":"Chul Gie Hong, Woo Dong Nam, Young Ju Lee, Dong-Ho Lee","doi":"10.31616/asj.2023.0207","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>This study aimed to evaluate how osteoporosis affected the clinical and radiological outcomes of patients who underwent anterior cervical discectomy and fusion (ACDF) with plating.</p><p><strong>Overview of literature: </strong>The incidence of complications associated with implants is high when ACDF is performed in patients with poor bone quality.</p><p><strong>Methods: </strong>In total, 101 patients without (T-score ≥1.0, group A) and 25 with (T-score ≤-2.5, group B) osteoporosis who underwent single-level ACDF with plating were followed up for >2 years. The clinical and radiological outcomes were compared between the two groups. The fusion rate and implant-related complications were evaluated.</p><p><strong>Results: </strong>Although clinical outcomes such as visual analog scale scores for the arm (2.0±2.3 vs. 2.4±2.9, p=0.490) and neck pain (1.4±1.9 vs. 1.8±2.2, p=0.343) and neck disability index (7.7±7.1 vs. 9.9±7.5, p=0.225) were slightly higher in group B, no statistically significant difference was noted. Cage subsidence (13.9% vs. 16.0%, p=0.755) and plate migration (7.9% vs. 8.0%, p=1.000) rates did not differ between the two groups. The fusion rate at 1 year postoperatively was higher in group A than in group B (80.3% vs. 68.2%, p=0.139) and slightly increased in both groups (94.6% vs. 86.4%, p=0.178) at the final follow-up.</p><p><strong>Conclusions: </strong>Osteoporosis did not significantly affect the rate of cage subsidence or plate migration after cervical fusion. After ACDF, increased cage subsidence and implant migration rates had no significant effect on clinical outcomes.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065514/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Spine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31616/asj.2023.0207","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Study design: Retrospective study.
Purpose: This study aimed to evaluate how osteoporosis affected the clinical and radiological outcomes of patients who underwent anterior cervical discectomy and fusion (ACDF) with plating.
Overview of literature: The incidence of complications associated with implants is high when ACDF is performed in patients with poor bone quality.
Methods: In total, 101 patients without (T-score ≥1.0, group A) and 25 with (T-score ≤-2.5, group B) osteoporosis who underwent single-level ACDF with plating were followed up for >2 years. The clinical and radiological outcomes were compared between the two groups. The fusion rate and implant-related complications were evaluated.
Results: Although clinical outcomes such as visual analog scale scores for the arm (2.0±2.3 vs. 2.4±2.9, p=0.490) and neck pain (1.4±1.9 vs. 1.8±2.2, p=0.343) and neck disability index (7.7±7.1 vs. 9.9±7.5, p=0.225) were slightly higher in group B, no statistically significant difference was noted. Cage subsidence (13.9% vs. 16.0%, p=0.755) and plate migration (7.9% vs. 8.0%, p=1.000) rates did not differ between the two groups. The fusion rate at 1 year postoperatively was higher in group A than in group B (80.3% vs. 68.2%, p=0.139) and slightly increased in both groups (94.6% vs. 86.4%, p=0.178) at the final follow-up.
Conclusions: Osteoporosis did not significantly affect the rate of cage subsidence or plate migration after cervical fusion. After ACDF, increased cage subsidence and implant migration rates had no significant effect on clinical outcomes.
研究设计目的:本研究旨在评估骨质疏松症如何影响接受带钢板颈椎前路椎间盘切除和融合术(ACDF)患者的临床和放射学结果:文献综述:骨质较差的患者进行 ACDF 时,植入物相关并发症的发生率较高:方法:对接受单层带钢板 ACDF 的 101 例无骨质疏松症患者(T 评分≥1.0,A 组)和 25 例有骨质疏松症患者(T 评分≤-2.5,B 组)进行了 2 年以上的随访。两组患者的临床和放射学结果进行了比较。结果:尽管B组的临床结果,如手臂(2.0±2.3 vs. 2.4±2.9,P=0.490)和颈部疼痛(1.4±1.9 vs. 1.8±2.2,P=0.343)的视觉模拟量表评分以及颈部残疾指数(7.7±7.1 vs. 9.9±7.5,P=0.225)略高,但无统计学差异。两组间的支架下沉率(13.9% vs. 16.0%,P=0.755)和钢板移位率(7.9% vs. 8.0%,P=1.000)无差异。A组术后1年的融合率高于B组(80.3% vs. 68.2%,P=0.139),在最终随访时,两组的融合率均略有上升(94.6% vs. 86.4%,P=0.178):结论:骨质疏松症对颈椎融合术后的骨架下沉率或钢板移位率无明显影响。结论:骨质疏松症对颈椎融合术后的骨架下沉率和钢板移位率没有明显影响。