Sheng Xia-Qing, Ding Chen, Wang Bei-Yu, Meng Yang, Liu Hao
Department of Orthopedic Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China.
Global Spine J. 2024 Mar;14(2):657-666. doi: 10.1177/21925682221120533. Epub 2022 Aug 16.
Retrospective study.
To explore preoperative segmental slope as a predictor of fusion rate after single-level anterior cervical discectomy and fusion (ACDF).
Data of consecutive patients with single-level cervical spondylosis who underwent ACDF between 2011 and January 2019 were retrospectively reviewed. Preoperative parameters including baseline characteristics, segment slope, T1 slope, range of motion, intervertebral disk height, and bone density were evaluated. Data were analyzed using Student's t-test, Mann-Whitney U test, χ2 test, Fisher's exact test, multivariate logistic regression analysis, and receiver operating characteristic curve.
In total, 253 patients were selected. The mean follow-up was 32.1 months (range 24-99 months). Male sex, body mass index, preoperative segment slope, T1 slope, operative levels, and osteoporosis or osteopenia were associated with non-fusion at an early stage after surgery. However, no statistically significant difference was observed at the last follow-up. Multivariate logistic regression analysis revealed that the preoperative segment slope was an independent predictor for non-fusion at 3, 6, and 12 months postoperatively. Osteoporosis or osteopenia was an independent predictor of non-fusion at 6 and 12 months postoperatively. The area under the curve was .874 at 3 months ( < .001, cutoff value 10.21°), .888 at 6 months ( < .001, cutoff value 14.56°), and .825 at 12 months ( < .001, cutoff value 21.08°).
Preoperative segment slope can be used as a predictor of early fusion rate after single-level ACDF. We determined detailed cutoff values. This study may help surgeons take measures to promote early fusion in advance.
回顾性研究。
探讨术前节段性斜率作为单节段颈椎前路椎间盘切除融合术（ACDF）后融合率的预测指标。
回顾性分析2011年至2019年1月期间连续接受ACDF治疗的单节段颈椎病患者的数据。评估术前参数，包括基线特征、节段斜率、T1斜率、活动范围、椎间盘高度和骨密度。采用学生t检验、曼-惠特尼U检验、χ²检验、费舍尔精确检验、多因素逻辑回归分析和受试者工作特征曲线进行数据分析。
共纳入253例患者。平均随访时间为32.1个月（范围24 - 99个月）。男性、体重指数、术前节段斜率、T1斜率、手术节段以及骨质疏松或骨质减少与术后早期未融合相关。然而，在末次随访时未观察到统计学显著差异。多因素逻辑回归分析显示，术前节段斜率是术后3、6和12个月未融合的独立预测指标。骨质疏松或骨质减少是术后6和12个月未融合的独立预测指标。术后3个月曲线下面积为0.874（P < 0.001，截断值10.21°），6个月为0.888（P < 0.001，截断值14.56°），12个月为0.825（P < 0.001，截断值21.08°）。
术前节段斜率可作为单节段ACDF术后早期融合率的预测指标。我们确定了详细的截断值。本研究可能有助于外科医生提前采取措施促进早期融合。
