The Severity of Preoperative Cervical Disc Degeneration Is an Important Risk Factor for Cervical Fusion Failure After Anterior Cervical Discectomy and Fusion

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2025-08-18 DOI:10.1155/ijcp/5439792

Bing Zhou, Youfeng Guo, Beiduo Shen, Haihong Zhao, Ziqi Zhu, Bin Yu, Tao Hu, Desheng Wu

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引用次数: 0

Abstract

Background: The relation between preoperative cervical disc degeneration and cervical fusion after anterior cervical discectomy and fusion (ACDF) remains unclear.

Methods: We reviewed patients who received ACDF from 2019 to 2021. The Pfirrmann grading system was applied to six cervical discs (C2–T1) based on preoperative magnetic resonance imaging. The total degeneration score of six cervical discs was calculated as D Score. A mean degeneration score of operative cervical discs (Mean Surgery D Score) was calculated by dividing the total degeneration score of operative cervical discs by the number of operative segments. Postoperative computed tomography (CT) scans were conducted to determine the result of cervical fusion. Univariate and multivariate logistic regressions were used to explore the risk factors for cervical fusion failure. The receiver operating characteristic (ROC) curves were drawn according to multivariate results.

Results: There were 159 patients in the nonfusion group and 135 patients in the fusion group. Univariate logistic regression showed that age, smoking, hypertension, coronary heart disease (CHD), D Score, and Mean Surgery D Score were associated with fusion failure. Hemoglobin, total protein, and albumin were associated with higher fusion rates. D Score (odds ratio [OR]: 1.887, 95%CI: 1.448–2.458, p = 0.001) and Mean Surgery D Score (OR: 8.827, 95%CI: 1.989–39.163, p = 0.004) were independent risk factors of fusion failure. The areas under the ROC curve of D Score and Mean Surgery D Score were 0.904 and 0.875, respectively.

Conclusions: Patients with a higher preoperative D Score (> 23.5) and Mean Surgery D Score (> 4.125) have a higher risk of fusion failure after ACDF.

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术前颈椎间盘退变的严重程度是前路颈椎间盘切除术融合后颈椎融合失败的重要危险因素

背景：术前颈椎间盘退变与前路颈椎间盘切除术融合（ACDF）后颈椎融合的关系尚不清楚。方法：我们回顾了2019年至2021年接受ACDF治疗的患者。根据术前磁共振成像对6个颈椎间盘（C2-T1）应用Pfirrmann分级系统。计算6个颈椎间盘退变总分为D分。用手术椎间盘退变总评分除以手术节段数计算手术椎间盘退变平均评分（mean Surgery D score）。术后进行计算机断层扫描（CT）以确定颈椎融合的结果。采用单因素和多因素logistic回归分析探讨颈椎融合失败的危险因素。根据多变量结果绘制受试者工作特征（ROC）曲线。结果：未融合组159例，融合组135例。单因素logistic回归显示，年龄、吸烟、高血压、冠心病、D评分和平均手术D评分与融合失败相关。血红蛋白、总蛋白和白蛋白与较高的融合率相关。D评分（比值比[OR]: 1.887, 95%CI: 1.448 ~ 2.458, p = 0.001）和Mean Surgery D评分（比值比[OR]: 8.827, 95%CI: 1.989 ~ 39.163, p = 0.004）是融合失败的独立危险因素。D评分和Mean Surgery D评分的ROC曲线下面积分别为0.904和0.875。结论：术前D评分（> 23.5）和手术平均D评分（> 4.125）较高的患者ACDF术后融合失败的风险较高。

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

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.