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An alternative method to evaluate lumbar interbody fusion status focusing on position change of screw-rod constructs

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The evaluation of lumbar interbody fusion status is generally subjective and may differ among raters. The authors examined whether the assessment of position change of screw-rod constructs could be an alternative method for the evaluation of fusion status.

Methods

Sixty-three patients undergoing lumbar interbody single-level fusion were retrospectively reviewed. Three-dimensional images of screw-rod constructs were created from baseline CT examination on the day after surgery and follow-up CT examinations (3–5 months, 6–11 months, and ≥ 12 months) and superposed, with position change of screw-rod constructs being evaluated by the distance between the 3-dimensional images at baseline and follow-up. The evaluation was repeated twice to confirm the reproducibility. Fusion status on follow-up CT examinations was assessed by three raters, where inter-rater reliability was evaluated with Fleiss’ kappa. The results of the fusion status were classified into fusion and incomplete fusion groups in each timing of follow-up CT examinations, where the amount of position change was compared between the two groups.

Results

The evaluation of position change was completely reproducible. The Fleiss’ kappa (agreements) was 0.481 (69.4%). The medians of the amount of position change in fusion and incomplete fusion groups were 0.134 mm and 0.158 mm at 3–5 months (p = 0.21), 0.160 mm and 0.190 mm at 6–11 months (p = 0.02), and 0.156 mm and 0.314 mm at ≥ 12 months (p = 0.004).

Conclusions

The assessment of position change of screw-rod constructs at 6 months or more after surgery can be an alternative method for evaluating lumbar interbody fusion status.

Key Points

• Lumbar interbody fusion status (satisfactory, incomplete, or failed) is associated with the quantification of position change of screw-rod in this study.

• Reference values for the evaluation of position change in identifying interbody fusion status are provided.

• Position change of screw-rod could be a supportive method for evaluating interbody fusion status.

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Abbreviations

3D:

3-dimensional

AUC:

Area under the receiver operating characteristic curve

CI:

Confidence interval

HU:

Hounsfield unit

ROC:

Receiver operating characteristic

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Neurosurgery, Suzuka Kaisei Hospital, 112-1 Ko-cho, Suzuka, Mie, 513-8505, Japan

    Atsushi Yamamoto & Masaki Mizuno

  2. Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie, 514-1101, Japan

    Satoru Tanioka, Munenari Ikezawa & Fujimaro Ishida

  3. Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Masashi Fujimoto, Hirofumi Nishikawa, Takahiro Miyazaki & Hidenori Suzuki

  4. Department of Neurosurgery, Mie Prefectural General Medical Center, 5450-132 Oaza Hinaga, Yokkaichi, Mie, 510-8561, Japan

    Yusuke Kamei

Authors
  1. Atsushi Yamamoto
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  2. Satoru Tanioka
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  3. Masashi Fujimoto
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  4. Hirofumi Nishikawa
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  5. Yusuke Kamei
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  6. Munenari Ikezawa
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  7. Fujimaro Ishida
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  8. Takahiro Miyazaki
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  9. Hidenori Suzuki
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  10. Masaki Mizuno
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Corresponding author

Correspondence to Satoru Tanioka.

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Guarantor

The guarantor is Satoru Tanioka.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was waived by the institutional review board.

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Methodology

• retrospective

• diagnostic study

• performed at one institution

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Yamamoto, A., Tanioka, S., Fujimoto, M. et al. An alternative method to evaluate lumbar interbody fusion status focusing on position change of screw-rod constructs. Eur Radiol 33, 1545–1552 (2023). https://doi.org/10.1007/s00330-022-09194-4

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  • DOI: https://doi.org/10.1007/s00330-022-09194-4

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