19 Harley St, London, W1G 9QJ, UK

Comparison of predictive value for cage subsidence between MRI-based endplate bone quality and vertebral bone quality scores following transforaminal lumbar interbody fusion: a retrospective propensity-matched study – Lumbar Fusion

Day Case Lumbar Fusion Surgery

The article investigates the predictive value of MRI-based vertebral bone quality (VBQ) and endplate bone quality (EBQ) scores for cage subsidence following transforaminal lumbar interbody fusion (TLIF). The study included 346 patients who underwent TLIF and had preoperative MRIs available. The patients were matched based on propensity scoring, and the association between radiographic factors and cage subsidence was analyzed. The results showed that higher VBQ and EBQ scores were significantly associated with a greater risk of cage subsidence. The EBQ score had greater specificity, indicating that it may perform better as a predictor. The study concludes that MRI-based VBQ and EBQ scores can be useful for assessing bone quality and predicting cage subsidence after TLIF

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated spinal centre in UK

Published article

: Higher VBQ and EBQ scores are associated with greater risk of cage subsidence following TLIF, and EBQ may perform better because of greater specificity.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine J. 2024 Jan 30:S1529-9430(24)00037-8. doi: 10.1016/j.spinee.2024.01.014. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Cage subsidence after lumbar fusion can lead to many adverse outcomes. Low bone mineral density (BMD) is a widely recognized risk factor for cage subsidence. Conventional methods can predict and evaluate BMD, but there are many shortcomings. Recently, MRI-based assessment of bone quality,

Spine J. 2024 Jan 30:S1529-9430(24)00037-8. doi: 10.1016/j.spinee.2024.01.014. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Cage subsidence after lumbar fusion can lead to many adverse outcomes. Low bone mineral density (BMD) is a widely recognized risk factor for cage subsidence. Conventional methods can predict and evaluate BMD, but there are many shortcomings. Recently, MRI-based assessment of bone quality in specific parts of the vertebral body has been proposed, including scores for vertebral bone quality (VBQ) and endplate bone quality (EBQ). However, the predictive accuracy of the two scoring systems for cage subsidence after transforaminal lumbar interbody fusion (TLIF) remains unknown. Therefore, we investigated MRI-based VBQ and EBQ scores for assessing bone quality and compared their predictive value for cage subsidence after TLIF.

PURPOSE: To compare the predictive value between MRI-based VBQ and EBQ scores for cage subsidence after TLIF.

STUDY DESIGN/SETTING: A retrospective case-control study PATIENTS SAMPLE: Patients with degenerative lumbar diseases underwent single-level TLIF at our medical center between 2014 and 2020, all of whom had preoperative MRIs available.

OUTCOMES MEASURES: Cage subsidence, disc height, VBQ score, EBQ score, upper and lower vertebral body bone quality (UL-VBQ) score.

METHODS: Data were retrospectively examined for a consecutive sample of 346 patients who underwent TLIF at our medical center between 2014 and 2020. Patients who subsequently experienced cage subsidence or not were matched to each other based on propensity scoring, and the two matched groups (52 patients each) were compared using conditional logistic regression to investigate the association between the potential radiographic factors and cage subsidence. Scores for VBQ and EBQ were assessed for their ability to predict cage subsidence in the matched patients based on the area under the receiver operative characteristic curve (AUC).

RESULTS: Among matched patients, those who suffered cage subsidence had significantly higher VBQ score (3.7 vs 3.1, p<0.001) and EBQ score (5.0 vs 4.3, p<0.001), and regression linked greater risk of subsidence to higher VBQ score (OR 4.557, 95% CI 1.076-19.291, p=0.039) and higher EBQ score (OR 5.396, 95% CI 1.158-25.146, p=0.032). A cut-off VBQ score of 3.4 predicted the cage subsidence among matched patients with an AUC of 0.799, sensitivity of 84.6% and specificity of 69.2%. A cut-off EBQ score of 4.7 predicted subsidence with an AUC of 0.829, sensitivity of 76.9% and specificity of 82.7%.

: Higher VBQ and EBQ scores are associated with greater risk of cage subsidence following TLIF, and EBQ may perform better because of greater specificity.

PMID:38301901 | DOI:10.1016/j.spinee.2024.01.014

The London Spine Unit : best situated spinal centre in UK

Read the original publication:

Comparison of predictive value for cage subsidence between MRI-based endplate bone quality and vertebral bone quality scores following transforaminal lumbar interbody fusion: a retrospective propensity-matched study

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Spine J. 2024 Jan 30:S1529-9430(24)00037-8. doi: 10.1016/j.spinee.2024.01.014. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Cage subsidence after lumbar fusion can lead to many adverse outcomes. Low bone mineral density (BMD) is a widely recognized risk factor for cage subsidence. Conventional methods can predict and evaluate BMD, but there are many shortcomings. Recently, MRI-based assessment of bone quality
Lumbar slipped Disc

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810