生物骨科材料与临床研究2025，Vol.22Issue(4)：48-53,6.DOI:10.3969/j.issn.1672-5972.2025.04.009
基于MRI的椎骨和终板骨质量评分在后路腰椎融合术后椎间融合器沉降中的预测价值
The predictive value of MRI-derived vertebral and endplate bone quality scores for cage subsidence following posterior lumbar interbody fusion
摘要
Abstract
Objective To assess the predictive value of MRI-derived vertebral bone quality(VBQ)and endplate bone quality(EBQ)scores for cage subsidence(CS)following posterior lumbar interbody fusion(PLIF)in a Chinese patient cohort,using quantitative computed tomography(QCT)as the reference standard for bone density measurement.Methods A retrospective analysis was performed on patients who underwent single-level PLIF surgery at Yichang Central People's Hospital from January 2020 to June 2023.Cage subsidence(CS)was defined as>2 mm reduction in mid-vertebral height on 12-month postoperative CT,with patients stratified into CS and non-CS groups accordingly.Demographic data,perioperative imaging,and surgical outcomes were collected.VBQ and EBQ scores were calculated using T1-weighted MRI,while bone density was assessed through QCT.CS was evaluated using postoperative CT imaging at 12 months.Statistical analyses,including t-tests,chi-square tests,receiver operating characteristic(ROC)curve analysis,and Pearson correlation analysis,were used to compare the predictive efficacy of QCT,VBQ and EBQ.Results A total of 141 patients were enrolled in this study.Radiographic evidence of CS was observed in 39 cases(27.7%,CS group),while the remaining 102 cases(72.3%)were categorized into the non-CS group.Patients with CS were older and had significantly lower QCT values(101.62±13.04 vs.147.12±34.57;P<0.05),higher VBQ scores(3.76±0.86 vs.2.85±0.58;P<0.05),and higher EBQ scores(5.05±1.01 vs.4.25±0.84;P<0.05).ROC curve analysis showed that QCT had the highest area under the curve(AUC)at 0.903,followed by VBQ(AUC=0.823)and EBQ(AUC=0.741).VBQ demonstrated superior sensitivity(87.2%)and specificity(69.6%)compared to EBQ for predicting CS.Conclusion MRI-derived VBQ scores demonstrated good predictive value for CS following PLIF,with greater clinical applicability than EBQ,particularly in evaluating overall vertebral bone quality in Chinese patients.Combining VBQ and EBQ scores may enhance individualized treatment planning and improve surgical outcomes in PLIF procedures.关键词
腰椎融合术/融合器沉降/椎体质量/终板骨质量/核磁共振Key words
Lumbar fusion/Cage subsidence/Vertebral body quality/Endplate bone quality/MRI分类
医药卫生引用本文复制引用
杨子健,梁杰,史大伟,吴宇,张帆..基于MRI的椎骨和终板骨质量评分在后路腰椎融合术后椎间融合器沉降中的预测价值[J].生物骨科材料与临床研究,2025,22(4):48-53,6.基金项目
2025年度宜昌市医疗卫生研究项目(A25-2-021) （A25-2-021）
