Assessing the Impact of Preoperative MRI-Based Vertebral Bone Quality Scores on Five-Year Prognosis in Lumbar Spine Surgery.

IF 2.6 2区医学 Q2 CLINICAL NEUROLOGY Spine Pub Date : 2025-02-15 Epub Date: 2024-05-16 DOI:10.1097/BRS.0000000000005040

Hiroshi Taniwaki, Masatoshi Hoshino, Yuki Kinoshita, Akira Matsumura, Takashi Namikawa, Minori Kato, Shinji Takahashi, Hiroaki Nakamura

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Abstract

Study design: Retrospective cohort study.

Objective: To assess the utility of preoperative vertebral bone quality (VBQ) scores in predicting the five-year clinical outcomes following lumbar spine surgery.

Summary of background data: Osteoporosis poses a significant concern in older adults undergoing spinal surgery. The VBQ score, assessed through preoperative magnetic resonance imaging (MRI), is associated with subsequent osteoporotic fractures and postoperative complications. However, previous report on the impact of VBQ score on mid-term clinical outcomes after lumbar spine surgery remains lacking.

Materials and methods: A total of 189 patients who underwent lumbar surgery (≤3 disc levels) for lumbar spinal stenosis between 2010 and 2016 were enrolled. Patients were classified into high (>3.35), middle (2.75-3.35), and low (<2.73) VBQ score groups based on tertiles. Clinical scores, including Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Short Form-36 (SF-36), were recorded preoperatively and one, two, and five years postoperatively.

Results: Comparative analysis showed significant differences among the VBQ groups throughout the study period in low back pain ( P =0.013), walking ability ( P =0.005), social life function ( P =0.010) of JOABPEQ, and physical component summary of the SF-36 ( P =0.018) following lumbar spine surgery. A higher VBQ score was significantly correlated with worse five-year postoperative outcomes for all domains except for lumbar function of the JOABPEQ using multiple linear regression analysis, adjusting for age, sex, BMI, hyperlipidemia, surgical procedures, and each preoperative score.

Conclusion: A high preoperative VBQ score is a risk factor for poor five-year clinical outcomes after lumbar spine surgery. Evaluation of the VBQ score through routine preoperative MRI facilitates osteoporotic screening in lumbar patients without radiation exposure and health care costs, while also demonstrating its potential as a prognostic indicator of postoperative clinical outcomes.

Level of evidence: Level III.

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评估术前基于磁共振成像的椎骨质量评分对腰椎手术 5 年预后的影响

研究设计回顾性队列研究：评估术前椎体骨质量（VBQ）评分在预测腰椎手术后 5 年临床结果中的作用：骨质疏松症是老年人接受脊柱手术的一个重要问题。通过术前磁共振成像（MRI）评估的 VBQ 评分与随后的骨质疏松性骨折和术后并发症有关。然而，此前仍缺乏有关 VBQ 评分对腰椎手术后中期临床结果影响的报告：2010年至2016年期间，共有189名患者因腰椎管狭窄接受了腰椎手术（≤3个椎盘水平）。患者被分为高位（>3.35）、中位（2.75 至 3.35）和低位（Results：比较分析表明，在整个研究期间，腰椎手术后各组患者在腰痛（P=0.013）、行走能力（P=0.005）、JOABPEQ的社会生活功能（P=0.010）和SF-36的体能部分总结（P=0.018）方面存在显著差异。通过多元线性回归分析，并对年龄、性别、体重指数、高脂血症、手术过程和术前各项评分进行调整，VBQ评分越高，术后5年预后越差，但JOABPEQ的腰椎功能除外：结论：术前VBQ评分过高是腰椎手术后5年临床疗效不佳的风险因素。通过常规术前磁共振成像评估 VBQ 评分有助于对腰椎病患者进行骨质疏松症筛查，且不会产生辐射和医疗费用，同时还证明了其作为术后临床预后指标的潜力：3.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine 医学-临床神经学

CiteScore

5.90

自引率

6.70%

发文量

361

审稿时长

6.0 months

期刊介绍： Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.