Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases

Abstract Background To investigate the correlation between vertebral Hounsfield unit (HU) values and cage subsidence in patients treated with stand-alone (SA) OLIF. Methods A retrospective review of collected data was performed on 76 patients who underwent SA OLIF. We utilized the HU value for lumba...

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Autores principales:	Jing Zhou, Chao Yuan, Chao Liu, Lei Zhou, Jian Wang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Oblique lumbar interbody fusion Hounsfield units Osteoporosis Cage subsidence Degenerative lumbar diseases Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/530f650c4ad54929bda1646d54d13e6d
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spelling	oai:doaj.org-article:530f650c4ad54929bda1646d54d13e6d2021-11-21T12:27:35ZHounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases10.1186/s12891-021-04833-11471-2474https://doaj.org/article/530f650c4ad54929bda1646d54d13e6d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04833-1https://doaj.org/toc/1471-2474Abstract Background To investigate the correlation between vertebral Hounsfield unit (HU) values and cage subsidence in patients treated with stand-alone (SA) OLIF. Methods A retrospective review of collected data was performed on 76 patients who underwent SA OLIF. We utilized the HU value for lumbar bone mineral density (BMD) obtained on preoperative CT. The vertebral HU values of patients with subsidence were compared to those without subsidence. The correlation between cage subsidence and clinical score was investigated. Results Sixteen patients (21.1%) had at least radiographic evidence of interbody cage subsidence. The average cage subsidence was 2.5 ± 1.3 mm (range 0.9-4.8 mm). There were no significant differences in sex, BMI, preoperative diagnoses, or fused level (p > 0.05); however, there were significant differences between the cage subsidence group and the nonsubsidence group in age, average of the lowest T-score, and average HU value, including for the L1 vertebrae, L1-L4 horizontal plane, and L1-L4 sagittal plane (p < 0.05). The average HU value of the L1-L4 horizontal plane showed a more predictable AUC of 0.909 (95% CI, 0.834–0.984; P < 0.001) compared with the average of the lowest T-score following an AUC of 0.791 (95% CI, 0.674–0.909; P < 0.001). Based on logistic regression analysis, the average HU value of the L1-L4 horizontal plane (OR, 0.912; 95% CI, 0.861–0.966; P = 0.002) was an independent factor influencing cage subsidence. Conclusions Patients with lower average HU values of the lumbar vertebrae are at a much higher risk of developing cage subsidence after SA OLIF. Measurement of preoperative HU values on preexisting CT scans could be rapid, simple and feasible.Jing ZhouChao YuanChao LiuLei ZhouJian WangBMCarticleOblique lumbar interbody fusionHounsfield unitsOsteoporosisCage subsidenceDegenerative lumbar diseasesDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Oblique lumbar interbody fusion Hounsfield units Osteoporosis Cage subsidence Degenerative lumbar diseases Diseases of the musculoskeletal system RC925-935
spellingShingle	Oblique lumbar interbody fusion Hounsfield units Osteoporosis Cage subsidence Degenerative lumbar diseases Diseases of the musculoskeletal system RC925-935 Jing Zhou Chao Yuan Chao Liu Lei Zhou Jian Wang Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
description	Abstract Background To investigate the correlation between vertebral Hounsfield unit (HU) values and cage subsidence in patients treated with stand-alone (SA) OLIF. Methods A retrospective review of collected data was performed on 76 patients who underwent SA OLIF. We utilized the HU value for lumbar bone mineral density (BMD) obtained on preoperative CT. The vertebral HU values of patients with subsidence were compared to those without subsidence. The correlation between cage subsidence and clinical score was investigated. Results Sixteen patients (21.1%) had at least radiographic evidence of interbody cage subsidence. The average cage subsidence was 2.5 ± 1.3 mm (range 0.9-4.8 mm). There were no significant differences in sex, BMI, preoperative diagnoses, or fused level (p > 0.05); however, there were significant differences between the cage subsidence group and the nonsubsidence group in age, average of the lowest T-score, and average HU value, including for the L1 vertebrae, L1-L4 horizontal plane, and L1-L4 sagittal plane (p < 0.05). The average HU value of the L1-L4 horizontal plane showed a more predictable AUC of 0.909 (95% CI, 0.834–0.984; P < 0.001) compared with the average of the lowest T-score following an AUC of 0.791 (95% CI, 0.674–0.909; P < 0.001). Based on logistic regression analysis, the average HU value of the L1-L4 horizontal plane (OR, 0.912; 95% CI, 0.861–0.966; P = 0.002) was an independent factor influencing cage subsidence. Conclusions Patients with lower average HU values of the lumbar vertebrae are at a much higher risk of developing cage subsidence after SA OLIF. Measurement of preoperative HU values on preexisting CT scans could be rapid, simple and feasible.
format	article
author	Jing Zhou Chao Yuan Chao Liu Lei Zhou Jian Wang
author_facet	Jing Zhou Chao Yuan Chao Liu Lei Zhou Jian Wang
author_sort	Jing Zhou
title	Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
title_short	Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
title_full	Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
title_fullStr	Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
title_full_unstemmed	Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
title_sort	hounsfield unit value on ct as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases
publisher	BMC
publishDate	2021
url	https://doaj.org/article/530f650c4ad54929bda1646d54d13e6d
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Hounsfield unit value on CT as a predictor of cage subsidence following stand-alone oblique lumbar interbody fusion for the treatment of degenerative lumbar diseases

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