Evaluating Surgical Cervical Arthrodesis With a Novel MRI Grading Score

Area of Science:

• Neurosurgery
• Radiology
• Spine Surgery

Background:

• Diagnostic workup for anterior cervical discectomy and fusion (ACDF) commonly uses MRI, CT, and X-rays.
• Reducing ionizing radiation exposure is a clinical priority.

Purpose of the Study:

• To evaluate a novel magnetic resonance imaging (MRI)-scoring system for differentiating arthrodesis from pseudoarthrosis post-ACDF.
• To assess the potential for MRI to replace CT and X-rays in the diagnostic workup.

Main Methods:

• A retrospective study evaluated 64 patients (109 levels).
• T1 and T2 signal intensities of the instrumented disk space, cerebrospinal fluid (CSF), and vertebral bodies (VB) were measured.
• Interbody scores (IIS) were calculated using ROI quotients (interspace/CSF and interspace/VB).

Main Results:

• The MRI scoring system showed significant differences between arthrodesis and pseudoarthrosis for both T1 and T2 weighted images (P <0.0001).
• The T1-interbody interbody score using the vertebral body (T1-IIS VB) demonstrated the highest discriminative capability (AUROC 0.7743).

Conclusions:

• A novel MRI scoring system effectively differentiates arthrodesis from pseudoarthrosis after ACDF.
• This MRI-based method could potentially eliminate the need for ionizing radiation-based imaging in symptomatic postoperative patients.