Lu Minming, Liang Cen, Tang Yifan, Gu Changjiang, Shi Bin, Li Yi, Yuan Bo, Liao Xinyuan, Chen Xiongsheng
Pain Medicine Department, Chengdu Wenjiang District People's Hospital, Chengdu, China.
The 3rd Affiliated Hospital of Chengdu Medical College & Pidu District People's Hospital, Chengdu, China.
Eur Spine J. 2025 Sep 12. doi: 10.1007/s00586-025-09242-9.
What are the optimal image magnification ratios for EBQ score measurement and the accuracy of this score in predicting titanium mesh cage (TMC) subsidence in patients with cervical ossification of the posterior longitudinal ligament (OPLL) after anterior cervical corpectomy and fusion (ACCF)?
107 cervical OPLL patients who had undergone single-level ACCF were included. Patients were stratified into subsidence and non-subsidence groups, paired by propensity score matching, and the predictive values of EBQ and VBQ scores for TMC subsidence were evaluated via receiver operating curve (ROC) and the area under the curve (AUC).
On radiographs, 75% and 100% magnifications showed better reliability than 25% and 50%, thus 75% was used. Higher EBQ, Global VBQ, U-L VBQ scores and older age are linked to higher TMC subsidence risk. In the cohort of matched patients, An EBQ threshold of 2.44 demonstrated predictive efficacy for TMC subsidence (AUC = 0.752, 78.8% sensitivity, 69.7% specificity). A U-L VBQ score threshold of 2.57 and Global VBQ score threshold of 2.56 both demonstrated good prediction of TMC subsidence. The former achieved 84.8% sensitivity and 57.6% specificity, while the latter showed 86.3% sensitivity with 52.4% specificity. The two matched groups had similar improvements in patient-reported outcomes including VAS score, NDI and mJOA score.
Higher EBQ score was an independent factor for TMC subsidence. Use of EBQ score of 2.44 as the cutoff value on preoperative MRIs magnified 75% yielded better reliability. Regarding the two scores, the EBQ score emerges as a more effective predictor.
在颈椎后纵韧带骨化症（OPLL）患者行颈椎前路椎体次全切除融合术（ACCF）后，用于测量EBQ评分的最佳图像放大率是多少，以及该评分预测钛网笼（TMC）下沉的准确性如何？
纳入107例行单节段ACCF的颈椎OPLL患者。通过倾向得分匹配将患者分为下沉组和非下沉组，并通过受试者工作特征曲线（ROC）和曲线下面积（AUC）评估EBQ和VBQ评分对TMC下沉的预测价值。
在X线片上，75%和100%放大率显示出比25%和50%更好的可靠性，因此采用75%放大率。较高的EBQ、整体VBQ、U-L VBQ评分以及较高年龄与较高的TMC下沉风险相关。在匹配患者队列中，EBQ阈值为2.44对TMC下沉具有预测效能（AUC = 0.752，灵敏度78.8%，特异度69.7%）。U-L VBQ评分阈值为2.57和整体VBQ评分阈值为2.56对TMC下沉均显示出良好的预测效果。前者灵敏度为84.8%，特异度为57.6%，而后者灵敏度为86.3%，特异度为52.4%。两组匹配患者在包括视觉模拟评分（VAS）、颈椎功能障碍指数（NDI）和改良日本骨科学会（mJOA）评分等患者报告结局方面有相似的改善。
较高的EBQ评分是TMC下沉的独立因素。术前MRI采用75%放大率并将EBQ评分的截断值设为2.44时可靠性更高。在这两个评分中，EBQ评分是更有效的预测指标。
