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Updated: Jul 9, 2025
Anterior Cervical Discectomy and Fusion in the Ovine Model
Published on: October 5, 2009
Cervical Vertebral Bone Quality Score Independently Predicts Zero-Profile Cage Subsidence After Single-Level Anterior
Zhe Wang1, Yong Huang1, Qian Chen2
1Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Objective:
This is the first study to evaluate the predictive value of the cervical vertebral bone quality (VBQ) score on zero-profile cage (ZPC)subsidence after anterior cervical discectomy and fusion (ACDF) using the Hounsfield units (HU) value of computed tomography as the reference.
Methods:
A total of 89 patients with at least 1 year of follow-up who underwent single-level ACDF with ZPC were retrospectively and consecutively included. VBQ and HU value were determined from preoperative T1-weighted magnetic resonance imaging and computed tomography. Subsidence was defined as ≥2 mm of migration of the cage into the superior or inferior endplate or both using lateral cervical spine radiography. The results were subjected to statistical analysis.
Results:
Subsidence was observed among 16 of the 89 study patients (Subsidence rate: 18.0%). The mean VBQ score was 2.94 ± 0.820 for patients with subsidence and 2.33 ± 0.814 for patients without subsidence. The multivariable analysis demonstrated that only an increased VBQ score (odds ratio: 1.823, 95% confidence interval : 0.918,3.620, P = 0.001) was associated with an increased rate of cage subsidence. There was a significant and moderate correlation between HU and VBQ (r = -0.507, P < 0.001). Using receiver operating characteristic curves, the area under the curve was 0.785, and the most appropriate threshold of VBQ was 2.68 (sensitivity 72.7%, specificity 82.1%).
Conclusions:
The VBQ score may be a valuable tool for independently predicting ZPC subsidence after single-level ACDF.
