What Cervical MRI Findings Can Tell About ACDF Outcomes and Risks of ASD.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-07-17 DOI:10.1097/BSD.0000000000001881

Olga Leonova, Evgenii Baykov, Aleksandr Krutko

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Abstract

Study design: A retrospective analysis of data on patients with cervical degenerative disc disease who underwent single-level anterior cervical discectomy and fusion (ACDF).

Objective: To determine the association between preoperative cervical MRI parameters and surgical outcomes, and their role in the adjacent segment disease (ASD).

Summary of background data: There is no evidence on what preoperative findings are related to ACDF outcomes, and the progression of postoperative degenerative changes at the adjacent levels has not been found yet.

Methods: The patients' demographic data, cervical MRI findings at all cervical levels and clinical data were collected preoperatively and postoperatively. A comparative analysis of MRIs of the levels adjacent and nondjacent to ACDF was performed to find out whether or not they were undergoing accelerated degeneration. A regression analysis was carried out for the identification of predictors of fusion rates and implant subsidence.

Results: The study included 121 patients at visit 1 and 83 at visit 2. The median follow-up duration was 26.5 [18.9; 33.1] months. Complete fusions were observed in 85.5% of the patients (71/83), and implant subsidence was observed in 40% of the patients (33/83). Neither failed fusions nor implant subsidence were significant to clinical data (P>0.05). Significant changes in the Modic changes ratio of type 1 to type 2 were observed 1 or 2 segments above ACDF (P>0.05), along with an increase in the endplate damage there (P<0.001). Endplate defects grade are a strong and independent predictor of implant subsidence at the same level (OR=1.3-12.94, P<0.05).

Conclusions: At the levels adjacent to and above the ACDF segment, there is a change in the Modic change type-to-type ratio and an increase in the endplate damage. However, these changes in MRI parameters cannot be regarded as evidence for accelerated segment degeneration due to ACDF. Endplate defects revealed on preoperative MRI scans are predictors of implant subsidence at the same level.

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宫颈MRI检查对ACDF结果和ASD风险的影响

研究设计：回顾性分析行单节段前路颈椎椎间盘切除术和融合术（ACDF）的颈椎退行性椎间盘病患者的资料。目的：探讨术前颈椎MRI参数与手术预后的关系及其在邻段病变（ASD）中的作用。背景资料总结：没有证据表明术前检查结果与ACDF结果相关，并且尚未发现相邻节段术后退行性改变的进展。方法：收集患者术前、术后人口统计学资料、各颈椎节段MRI表现及临床资料。对毗邻和非毗邻ACDF的mri水平进行比较分析，以确定它们是否正在加速变性。进行了回归分析，以确定融合率和种植体沉降的预测因子。结果：该研究包括121例第一次就诊患者和83例第二次就诊患者。中位随访时间为26.5 [18.9；33.1)个月。85.5%的患者（71/83）出现完全融合，40%的患者（33/83）出现种植体下沉。融合失败和种植体下沉对临床数据均无显著影响（P < 0.05）。在ACDF以上1节段和2节段，1型和2型的Modic变化比发生显著变化（P < 0.05），终板损伤增加（P < 0.05）。结论：在ACDF节段附近及以上的水平，Modic变化型比发生变化，终板损伤增加。然而，这些MRI参数的变化不能作为ACDF导致的节段加速退变的证据。术前MRI扫描显示终板缺损是同一水平植入物下沉的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.