The cervical spine demonstrates less postoperative bone loss than the lumbar spine.
Stephan N SalzmannIchiro OkanoCourtney Ortiz MillerErika ChiapparelliMarie-Jacqueline ReisenerDominik Adl AminiFabian WinterJennifer ShueJohn A CarrinoAndrew A SamaFrank P CammisaFederico P GirardiAlexander P HughesPublished in: Journal of orthopaedic research : official publication of the Orthopaedic Research Society (2021)
The objective of this study is to determine the bone mineral density (BMD) changes in adjacent vertebra following anterior cervical discectomy and fusion (ACDF). Consecutive patients undergoing ACDF with available preoperative and postoperative computed tomography (CT) imaging were included. Quantitative CT measurements of screw-free cervical and first thoracic vertebra were performed. Comparisons between pre- and postoperative BMD in the vertebrae one or two levels above the upper instrumented vertebra (UIV + 1, UIV + 2) and one level below the lowest instrumented vertebra (LIV + 1) were assessed. Seventy-two patients (men, 66.7%) met the inclusion criteria. The patient population was 91.7% Caucasian with a mean age of 55.0 years. The mean interval (±SD) between surgery and secondary CT was 157 ± 23 days. Preoperative BMD (±SD) in UIV + 1 was 300.6 ± 66.2 mg/cm3 . There was a significant BMD loss of 1.5% at UIV + 1 after surgery, resulting in a postoperative BMD of 296.2 ± 64.8 mg/cm3 (p = .029). At UIV + 2 and LIV + 1, no significant differences between pre- and postoperative BMD (304.7 ± 75.7 mg/cm3 vs. 299.8 ± 74.3 mg/cm3 , 197.3 ± 50.4 mg/cm3 vs. 200.8 ± 48.7 mg/cm3 , p = .113 and p = .078, respectively) were observed. Clinical significance Our results demonstrate a small BMD decrease of 1.5% at UIV + 1. This suggests that the effect of ACDF surgery on the adjacent levels might be smaller compared to the previously described lumbar BMD loss of 10%-20% following posterior lumbar fusion procedures.
Keyphrases
- patients undergoing
- computed tomography
- minimally invasive
- bone mineral density
- dual energy
- image quality
- contrast enhanced
- positron emission tomography
- end stage renal disease
- magnetic resonance imaging
- high resolution
- bone loss
- postmenopausal women
- newly diagnosed
- chronic kidney disease
- body composition
- atrial fibrillation
- prognostic factors
- case report
- spinal cord injury
- coronary artery disease
- spinal cord
- surgical site infection