Comparative analysis of novel vertebral bone quality score variants for predicting cage subsidence following single-level anterior cervical discectomy and fusion: a retrospective cohort study.
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引用次数: 0
Abstract
Background: Several modifications of the MRI-derived vertebral bone quality (VBQ) score have been proposed to improve assessment of vertebral bone quality, including anterior-modified, posterior-modified, calibrated, and T2-weighted adaptations. However, these methodologies have not been systematically evaluated in the cervical spine. This study compared the performance of VBQ-derived metrics for predicting cage subsidence following single-level anterior cervical discectomy and fusion (ACDF).
Methods: Patients undergoing single-level ACDF with preoperative MRI and postoperative radiographic follow-up were retrospectively analysed. Traditional VBQ, anterior-modified VBQ (MVBQ), posterior-modified VBQ (PVBQ), calibrated VBQ (cVBQ), and T2-weighted scores were calculated from preoperative MRI. Associations with cage subsidence and predictive performance were evaluated using multivariable logistic regression and receiver operating characteristic analysis.
Results: A total of 170 patients were included, of whom 67 (39.4%) developed cage subsidence. All T1-weighted bone quality metrics were significantly higher in patients with subsidence and remained independently associated after adjustment for clinical and surgical factors. Among the evaluated methodologies, cVBQ demonstrated the strongest association with subsidence and the highest discriminatory performance (AUC: 0.83). T2-weighted metrics showed weaker predictive ability, with one methodology demonstrating no significant association with subsidence.
Conclusion: MRI-derived bone quality metrics are associated with cage subsidence following single-level ACDF. Among the evaluated approaches, cVBQ demonstrated the highest predictive performance, supporting its potential role as a practical tool for preoperative risk stratification and identification of patients at increased risk of mechanical complications.
期刊介绍：
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe
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