ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Modified vertebral bone quality score is a better predictor of cage subsidence after transforaminal lumbar interbody fusion and is superior to vertebral bone quality score.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to compare the effectiveness of the modified vertebral bone quality (MVBQ) score and the traditional vertebral bone quality (VBQ) score in predicting cage subsidence following transforaminal lumbar interbody fusion (TLIF), using quantitative computed tomography (QCT) for validation.
methodsWe performed a retrospective analysis of patients who underwent single-level TLIF surgery for spinal degeneration between 2014 and 2022. VBQ and MVBQ scores are calculated based on T1-weighted MRI. Standard L1/2 volume bone mineral density (vBMD) was measured using preoperative lumbar CT images. Disc height and cage subsidence were measured using mid-sagittal CT images. All patients were divided into cage subsidence group and non-subsidence group, and statistical analysis was performed.
resultsA total of 359 patients were included in the study, and 55 (15.3%) experienced cage subsidence. There were significant differences in gender, QCT-vBMD, VBQ score, and MVBQ score between the cage subsidence and non-subsidence groups. Multivariate logistic regression analysis revealed that gender, QCT-vBMD, VBQ score, and MVBQ score were important factors for cage subsidence. Both VBQ and MVBQ scores were inversely correlated with QCT-vBMD, with MVBQ score showing a better correlation (r = -0.376, p < 0.001 vs. r = -0.300, p < 0.001). ROC analysis showed that the MVBQ score was superior to the VBQ score in predicting cage subsidence (AUC 0.802 vs. 0.780).
conclusionBoth VBQ and MVBQ scores are effective in predicting postoperative cage subsidence after TLIF and can serve as simple, convenient, and reliable preoperative assessment tools. The MVBQ score demonstrates a relatively better predictive effect than the VBQ score.
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