Predictive value of MRI-based vertebral bone quality score and endplate bone quality score for cage subsidence after transforaminal lumbar interbody fusion
Objective To explore the predictive value of MRI-based vertebral bone quality(VBQ)score and endplate bone quality(EBQ)score for cage subsidence after transforaminal lumbar interbody fusion(TLIF).Methods Two hundred and twenty-six patients undergoing TLIF for degenerative lumbar disease in our hospital were selected.The patients were divided into a subsidence group and a non-subsidence group according to whether there was cage subsidence after surgery.The scores of VBQ and EBQ were compared between the two groups.Risk factors for cage subsidence were investigated by using multivariate logistic regression analysis.The VBQ and EBQ scores were assessed for their ability to predict cage subsidence in patients based on the area under the receiver operative characteristic curve(AUC).Results Among the 226 patients,there were 30 with cage subsidence.The VBQ scores were(3.8+0.4)and the EBQ scores were 5.1+0.7 in the subsidence group.These were significantly higher than VBQ scores(3.1+0.6)and EBQ scores(4.2+1.0)in the non-subsidence group(P＜0.001).Multiple regression analysis showed that a higher risk of subsidence was associated with a higher VBQ score(OR=4.258,95%CI:1.983～9.142,P＜0.001)and a higher EBQ score(OR=1.971,95%CI:1.212～3.203,P=0.006).The ROC curve analysis showed that the AUC of VBQ was 0.843 and the AUC of EBQ was 0.864,respectively.The optimal thresholds for VBQ and EBQ scores to predict cage subsidence were 3.480(sensitivity=90%and specificity=75.5%)and 4.620(sensitivity=96.7%and specificity=74.5%),respectively.Conclusions The higher the preoperative VBQ or EBQ scores,the higher the risk of postoperative cage subsidence after TLIF.Among the two indicators,EBQ may be a better predictor of cage subsidence after fusion.
Vertebral bone quality scoreEndplate bone quality scoreMRITLIFCage subsidence
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