What Cervical MRI Findings Can Tell About ACDF Outcomes and Risks of ASD

Area of Science:

• Spine surgery
• Degenerative disc disease
• Radiology

Background:

• Limited evidence exists on preoperative findings predicting outcomes of anterior cervical discectomy and fusion (ACDF).
• Postoperative degenerative changes at adjacent spinal levels after ACDF are not well understood.

Purpose of the Study:

• To investigate the association between preoperative cervical MRI parameters and surgical outcomes.
• To determine the role of these parameters in adjacent segment disease (ASD) following ACDF.

Main Methods:

• Retrospective analysis of 121 patients with cervical degenerative disc disease undergoing single-level ACDF.
• Collected preoperative and postoperative demographic, clinical, and cervical MRI data.
• Performed comparative MRI analysis and regression analysis to identify predictors of fusion and subsidence.

Main Results:

• Complete fusion occurred in 85.5% of patients; implant subsidence in 40%.
• Significant changes in Modic changes ratio and increased endplate damage were observed at levels adjacent to ACDF.
• Preoperative endplate defect grade independently predicted implant subsidence (OR=1.3-12.94, P<0.05).

Conclusions:

• ACDF is associated with altered Modic changes and increased endplate damage at adjacent levels, but not necessarily accelerated degeneration.
• Preoperative endplate defects are significant predictors of same-level implant subsidence.