• Eur Spine J · Sep 2023

    MRI-based vertebral bone quality score for predicting cage subsidence by assessing bone mineral density following transforaminal lumbar interbody fusion: a retrospective analysis.

    • Youwei Ai, Qian Chen, Yong Huang, Hong Ding, Juehan Wang, Ce Zhu, Yueming Song, Ganjun Feng, and Limin Liu.
    • Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
    • Eur Spine J. 2023 Sep 1; 32 (9): 316731753167-3175.

    PurposeThis is the first study to evaluate the predictive value of the vertebral bone quality (VBQ) score on cage subsidence after transforaminal lumbar interbody fusion (TLIF) in a Chinese population using the spinal quantitative computed tomography (QCT) as the clinical standard. Meanwhile, the accuracy of the MRI-based VBQ score in bone mineral density (BMD) measurement was verified.MethodsWe performed a retrospective study of patients who underwent single-level TLIF from 2015 to 2020 with at least 1 year of follow-up. Cage subsidence was measured using postoperative radiographic images based on cage protrusion through the endplates more than 2 mm. The VBQ score was measured on T1-weighted MRI. The results were subjected to statistical analysis.ResultsA total of 283 patients (61.1% of female) were included in the study. The subsidence rate was with 14.1% (n = 40), and the average cage subsidence was 2.3 mm. There was a significant difference in age, sex, VBQ score and spinal QCT between the subsidence group and the no-subsidence group. The multivariable analysis demonstrated that only an increased VBQ score (OR = 2.690, 95% CI 1.312-5.515, p = 0.007) and decreased L1/2 QCT-vBMD (OR = 0.955, 95% CI 0.933-0.977, p < 0.001) were associated with an increased rate of cage subsidence. The VBQ score was found to be moderately correlated with the spinal QCT (r = -0.426, p < 0.001). The VBQ score was shown to significantly predict cage subsidence, with an accuracy of 82.5%.ConclusionOur findings indicate that the MRI-based VBQ score is a significant predictor of cage subsidence and could be used to assess BMD.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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