Evidence map›Paper›PMID 38965626›Full record

ArticleJournal of orthopaedic surgery and research2024

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics.

Haitao Lu, Wei Zhang, Zihao Chai, Xiubo Ge, Haiyang Yu

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Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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2 citing papers in PubMed.

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5 · Who and what money

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5 authors.

Haitao LuDepartment of Orthopedics, Fuyang People's Hospital of Bengbu Medical University(Fuyang People's Hospital), 501 Sanqing Road, Fuyang, Anhui, 236000, China.
Wei ZhangDepartment of Orthopedics, Fuyang People's Hospital of Bengbu Medical University(Fuyang People's Hospital), 501 Sanqing Road, Fuyang, Anhui, 236000, China.
Zihao ChaiDepartment of Orthopedics, Fuyang Sixth People 's Hospital, 2019 Huaihe Road, Fuyang, Anhui, 236000, China.
Xiubo GeDepartment of Orthopedics, Fuyang People's Hospital of Bengbu Medical University(Fuyang People's Hospital), 501 Sanqing Road, Fuyang, Anhui, 236000, China.
Haiyang YuDepartment of Orthopedics, Fuyang People's Hospital of Bengbu Medical University(Fuyang People's Hospital), 501 Sanqing Road, Fuyang, Anhui, 236000, China. fy.yhy@163.com.

Funding

Anhui Provincial Department of Science and Technology project 202304295107020118National Clinical Medical Research Center for Orthopaedics and Sports Rehabilitation Innovation Fund (2021-NCRC-CXJJ-PY-35)
6 · The paper itself

Abstract

backgroundPoor neurological recovery in patients after anterior cervical discectomy and fusion has been frequently reported; however, no study has analyzed the preoperative imaging characteristics of patients to investigate the factors affecting surgical prognosis. The purpose of this study was to investigate the factors that affect the preoperative imaging characteristics of patients and their influence on poor neurologic recovery after anterior cervical discectomy and fusion.

methodsWe retrospectively analyzed the clinical data of 89 patients who met the criteria for anterior cervical discectomy and fusion for the treatment of single-level cervical spondylotic myelopathy and evaluated the patients' neurological recovery based on the recovery rate of the Japanese Orthopaedic Association (JOA) scores at the time of the final follow-up visit. Patients were categorized into the "good" and "poor" groups based on the JOA recovery rates of ≥ 50% and < 50%, respectively. Clinical information (age, gender, body mass index, duration of symptoms, preoperative JOA score, and JOA score at the final follow-up) and imaging characteristics (cervical kyphosis, cervical instability, ossification of the posterior longitudinal ligament (OPLL), calcification of herniated intervertebral discs, increased signal intensity (ISI) of the spinal cord on T2-weighted imaging (T2WI), and degree of degeneration of the discs adjacent to the fused levels (cranial and caudal) were collected from the patients. Univariate and binary logistic regression analyses were performed to identify risk factors for poor neurologic recovery.

resultsThe mean age of the patients was 52.56 ± 11.18 years, and the mean follow-up was 26.89 ± 11.14 months. Twenty patients (22.5%) had poor neurological recovery. Univariate analysis showed that significant predictors of poor neurological recovery were age (p = 0.019), concomitant OPLL (p = 0.019), concomitant calcification of herniated intervertebral discs (p = 0.019), ISI of the spinal cord on T2WI (p <0.05), a high grade of degeneration of the discs of the cranial neighboring levels (p <0.05), and a high grade of discs of the caudal neighboring levels (p <0.05). Binary logistic regression analysis showed that ISI of the spinal cord on T2WI (p = 0.001 OR = 24.947) and high degree of degeneration of adjacent discs on the cranial side (p = 0.040 OR = 6.260) were independent risk factors for poor neurological prognosis.

conclusionISI of the spinal cord on T2WI and high degree of cranial adjacent disc degeneration are independent risk factors for poor neurological recovery after anterior cervical discectomy and fusion. A comprehensive analysis of the patients' preoperative imaging characteristics can help in the development of surgical protocols and the management of patients' surgical expectations.

Indexed as

Cervical VertebraeDiskectomyRecovery of FunctionSpinal FusionAdultAgedFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesRisk FactorsSpondylosisTreatment OutcomeAnterior cervical discectomy and fusionImaging characteristicsRisk factors

Identifiers

PMID38965626
PMCPMC11223388

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.