Endplate volumetric bone mineral density measured by quantitative computed tomography as a novel predictive measure of severe cage subsidence after standalone lateral lumbar fusion.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Ichiro OkanoAlexander P Hughes

Abstract

Quantitative computed tomography (QCT) is an alternate imaging method to dual X-ray absorptiometry to measure bone mineral density (BMD). One advantage of QCT is that it allows site-specific volumetric BMD (vBMD) measurements in a small region. In this study, we utilized site-specific, endplate vBMD (EP-vBMD) as a potential predictive marker of severe cage subsidence in standalone lateral lumbar interbody fusion (SA-LLIF) patients and conducted a retrospective comparative study between EP-vBMD and trabecular vBMDs (Tb-vBMD) in the vertebrae. Patients undergoing SA-LLIF from 2007 to 2016 were retrospectively reviewed. EP-vBMD was defined as the average of the upper and lower endplate volumetric BMDs measured in cortical and trabecular bone included in a 5-mm area of interest beneath the cage contact surfaces. We compared Tb-vBMDs and EP-vBMDs between disk levels that had severe cage subsidence and levels with no severe subsidence. Both EP-vBMD and Tb-vBMD could be measured in 210 levels of 96 patients. Severe cage subsidence was observed in 58 levels in 38 patients. Median (IQR) Tb-vBMD was 120.5 mg/cm3 (100.8-153.7) in the non-severe subsidence group and 117.9 mg/cm3 (90.6-149.5) in the severe subsidence group (p = 0.393), wher...Continue Reading

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Citations

Feb 15, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Hao LiGang Chen
Mar 16, 2021·The Spine Journal : Official Journal of the North American Spine Society·Conor JonesAlexander P Hughes
Aug 7, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Hao LiQixin Chen

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