Comparative analysis of endplate volumetric bone mineral density and endplate vertebral bone quality for predicting cage subsidence in lateral lumbar interbody fusion

作者：Hanming Bian, Lianyong Wang, Genghao Wang, Y Weng, Wentao Wan, Xiaopeng Li, Chao Chen, Xun Sun, Dong Zhao, Xigao Cheng, Yang Cao, William W. Lu, Zheng Wang, Qiang Yang · 发表于：Journal of Neurosurgery Spine · 年份：2025 · DOI：10.3171/2025.4.spine25140 · 被引用次数：3 · 研究领域：Spine and Intervertebral Disc Pathology、Bone health and osteoporosis research、Spinal Fractures and Fixation Techniques

OBJECTIVE: The aim of this study was to compare the predictive efficacy of quantitative CT (QCT)-based endplate volumetric bone mineral density (EP-vBMD) and MRI-based endplate vertebral bone quality (EBQ) score for cage subsidence (CS) after lateral lumbar interbody fusion (LLIF). METHODS: A retrospective study was conducted on patients who underwent single-level LLIF in conjunction with pedicle screw fixation at the authors' institution between January 2019 and April 2023. The volumetric bone mineral density (vBMD) was measured based on preoperative CT using phantom-less QCT software. Measurement of the VBQ score was based on preoperative MRI. CS was defined as a decrease of more than 2 mm in the midpoint height of the intervertebral space. The receiver operating characteristic (ROC) curve of the EP-vBMD and EBQ for predicting CS was drawn, and the predictive efficacy of the two methods was compared using the Delong test. Clinical outcomes, including the visual analog scale for low back pain (VAS-BP), VAS for leg pain (VAS-LP), and Oswestry Disability Index (ODI) scores were assessed preoperatively, postoperatively, and at the 1-year follow-up. RESULTS: Ninety-seven patients who underwent LLIF were included in this study, including 31 patients with CS and 66 patients with no CS (NCS). No significant differences were observed between the two groups in VAS-BP, VAS-LP, or ODI scores preoperatively, postoperatively, or at the 1-year follow-up (all p > 0.05). The EP-vBMD of the ...