Cervical spine MRI phenotypes and prediction of pain, disability and adjacent segment degeneration/disease after ACDF.
Adult
Aged
Cervical Vertebrae
/ diagnostic imaging
Diskectomy
Female
Humans
Intervertebral Disc Degeneration
/ diagnostic imaging
Intervertebral Disc Displacement
/ diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Pain, Postoperative
/ diagnostic imaging
Patient Reported Outcome Measures
Retrospective Studies
Spinal Fusion
cervical
classification
degeneration
disc
spine
Journal
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
Titre abrégé: J Orthop Res
Pays: United States
ID NLM: 8404726
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
29
11
2019
accepted:
06
03
2020
pubmed:
12
3
2020
medline:
5
5
2021
entrez:
12
3
2020
Statut:
ppublish
Résumé
Degenerative spine imaging findings have been extensively studied in the lumbar region and are associated with pain and adverse clinical outcomes after surgery. However, few studies have investigated the significance of these imaging "phenotypes" in the cervical spine. Patients with degenerative cervical spine pathology undergoing anterior cervical discectomy and fusion (ACDF) from 2008 to 2015 were retrospectively and prospectively assessed using preoperative MRI for disc degeneration, narrowing, and displacement, high-intensity zones, endplate abnormalities, Modic changes, and osteophyte formation from C2-T1. Points were assigned for these phenotypes to generate a novel Cervical Phenotype Index (CPI). Demographics were evaluated for association with phenotypes and the CPI using forward stepwise regression. Bootstrap sampling and multiple imputations assessed phenotypes and the CPI in association with patient-reported outcomes (Neck Disability Index [NDI], Visual Analog Scale [VAS]-neck, VAS-arm) and adjacent segment degeneration (ASDeg) and disease (ASDz). Of 861 patients, disc displacement was the most common (99.7%), followed by osteophytes (92.0%) and endplate abnormalities (57.3%). Most findings were associated with age and were identified at similar cervical vertebral levels; at C5-C7. Imaging phenotypes demonstrated both increased and decreased associations with adverse patient-reported outcomes and ASDeg/Dz. However, the CPI consistently predicted worse NDI (P = .012), VAS-neck (P = .007), and VAS-arm (P = .013) scores, in addition to higher odds of ASDeg (P = .002) and ASDz (P = .004). The CPI was significantly predictive of postoperative symptoms of pain/disability and ASDeg/Dz after ACDF, suggesting that the totality of degenerative findings may be more clinically relevant than individual phenotypes and that this tool may help prognosticate outcomes after surgery.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
657-670Informations de copyright
© 2020 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
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