Cervical Vertebra Bone Quality Score Predicts Zero-Profile Anchored Spacer Interbody Fusion Cage Subsidence after Anterior Cervical Diskectomy and Fusion: A Retrospective Study

Ningning Feng; Wenhao Li; Xing Yu; He Zhao; Ziye Qiu; Jianbin Guan; Guozheng Jiang; Kaitan Yang

doi:10.1177/21925682241280258

Cervical Vertebra Bone Quality Score Predicts Zero-Profile Anchored Spacer Interbody Fusion Cage Subsidence after Anterior Cervical Diskectomy and Fusion: A Retrospective Study

Global Spine J. 2024 Aug 31:21925682241280258. doi: 10.1177/21925682241280258. Online ahead of print.

Authors

Ningning Feng¹, Wenhao Li¹, Xing Yu¹, He Zhao¹, Ziye Qiu¹, Jianbin Guan², Guozheng Jiang¹, Kaitan Yang²

Affiliations

¹ Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
² Honghui Hospital Affiliated to Xi 'an Jiaotong University, Shannxi, China.

Abstract

Study design: Retrospective study.

Objective: This retrospective study primary focus is to investigate the relationship between the C-VBQ score and the occurrence of postoperative zero-profile anchored spacer (ROI-C) interbody fusion cage subsidence. Additionally, we aim to evaluate the predictive efficacy of the C-VBQ scoring system for subsidence in the context of ACDF with the ROI-C.

Methods: Patients who underwent ACDF with the ROI-C cage at our hospital between January 2016 and December 2022 were included in this study. Univariate analysis and multivariate logistic regression were employed to identify independent risk factors associated with ROI-C cage subsidence after ACDF. Pearson correlation analysis was utilized to assess the correlation between the C-VBQ score and the height of ROI-C cage subsidence.

Results: A total of 102 patients underwent ACDF with ROI-C in our hospital were included in this study. Univariate analysis showed that age (P = 0.021) and C-VBQ score (P < 0.001) were the influencing factors of cage subsidence. Pearson correlation analysis showed that there was a significant positive correlation between the subsidence height of ROI-C cage and C-VBQ (r = 0.55, P < 0.01). Multivariate binary logistic regression analysis showed that C-VBQ score was the only variable that could significantly predict the subsidence of ROI-C cage after ACDF. Higher C-VBQ score was significantly associated with cage subsidence (P < 0.001).The AUC was 0.89, and the cutoff value for C-VBQ was 2.70.

Conclusion: The findings indicate a significant correlation between a higher C-VBQ score before surgery and ROI-C cage subsidence after ACDF. The preoperative assessment of C-VBQ proves valuable for clinicians, enabling them to identify patients with low bone mineral density and predict the risk of zero-profile anchored spacer interbody fusion cage subsidence following ACDF.

Keywords: MRI; anterior cervical diskectomy and fusion; cage subsidence; cervical vertebral bone quality score; zero-profile anchored spacer (ROI-C) interbody fusion cage.