Endplate Degeneration and Intervertebral Vacuum Phenomenon Are Positively Correlated: A Retrospective Study in Patients Undergoing Lumbar Fusion Surgery.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-04-01 DOI:10.1097/BSD.0000000000001683

Gaston Camino-Willhuber, Lukas Schönnagel, Erika Chiapparelli, Paul Kohli, Krizia Amoroso, Ali E Guven, Thomas Caffard, Gisberto Evangelisti, Bruno Verna, Jiaqi Zhu, Jennifer Shue, Gbolabo Sokunbi, William D Zelenty, Mariana Bendersky, Federico P Girardi, Andrew A Sama, Frank P Cammisa, Alexander P Hughes

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引用次数: 0

Abstract

Study design: Retrospective cohort study.

Objective: To analyze the correlation between intervertebral vacuum phenomenon (IVP) severity and total endplate damage score [total endplate score (TEPS)].

Background: IVP severity and the TEPS are degenerative changes of the disc and endplate, respectively.

Methods: We retrospectively analyzed a cohort of patients undergoing lumbar fusion surgery due to degenerative disease between 2013 and 2021. Computer tomography was used to classify the severity of the IVP at each lumbar level and as a combined lumbar score (Lumbar Vacuum Severity Scale). Magnetic resonance imaging was used to classify endplate degeneration by the TEPS. The correlation between the combined lumbar IVP and TEPS was analyzed through a multivariable regression model.

Results: A total of 317 patients were analyzed with a median age of 63 years (interquartile range: 55-71.2), and 48.9% (n = 155) were females. In all lumbar levels, the median TEPS was 4 (interquartile range: 2-8). The severity of the TEPS was significantly associated with an increased odds ratio (OR) of having more severe IVP (OR: 1.78, 95% CI: 1.62-1.95, P < 0.001). After adjusting for multiple confounders, this relationship remained significant (OR: 1.32, 95% CI: 1.17-1.49, P < 0.001). Other independent significant influences were age (OR: 1.07, 95% CI: 1.04-1.10, P < 0.001) and the Pfirrmann grade (OR: 7.44, 95% CI: 4.40-12.58, P < 0.001). The analysis of the relationship between the combined lumbar vacuum score and lumbar endplate score was significant, with a beta-coefficient (β) of 0.24 (95% CI: 0.20-0.28, P < 0.001).

Conclusion: We found a significant correlation between IVP and TEPS in patients undergoing spine fusion surgery. These results support the theory that endplate damage could play a role in the pathogenesis of IVP.

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.