High Endplate Hounsfield Units Value Indicate Intervertebral Disc Degeneration Following Transforaminal Lumbar Interbody Fusion Surgery

• Published in: Orthopaedic surgery Vol. 15; no. 9; pp. 2291 - 2299
• Main Authors: Zheng, Huo‐Liang, Li, Bo, Song, Shao‐Kuan, Jiang, Lei‐Sheng, Zheng, Xin‐Feng, Jiang, Sheng‐Dan
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01-09-2023; John Wiley & Sons, Inc; Wiley
• Subjects: Back surgery; Body mass index; Bone density; Calcification; Clinical; Clinical outcomes; Degenerative disc disease; Endplate; Females; Hounsfield Unit; Lumbar Disc Degeneration; Magnetic resonance imaging; Pain; Quality of life; Tomography; Transforaminal Lumbar Interbody Fusion; Vertebrae
• ISSN: 1757-7853; 1757-7861
• DOI: 10.1111/os.13793

Objective
Lumbar disc degeneration (LDD) is a common cause of low back pain and disability, and its prevalence increases with age. The aim of this study is to investigate whether endplate Hounsfield unit (HU) values have an effect on lumbar disc degeneration (LDD) after transforaminal lumbar interbody fusion (TLIF) surgery in patients with degenerative lumbar stenosis.
Methods
This study was a retrospective analysis of patients who underwent TLIF surgery in January 2016 to October 2019. One hundred and fifty‐seven patients who underwent TLIF surgery for degenerative lumbar stenosis were enrolled in this study. Demographic data was recorded. VAS and ODI values were compared to assess the surgical outcomes in patients with or without process of LDD after TLIF surgery. Correlation analysis was performed to investigate associations between LDD and endplate HU value. Binary logistic regression analysis was carried out to study relationships between the DDD and the multiple risk factors.
Results
There was a statistically significant correlation between LDD, body mass index (BMI), age, paraspinal muscle atrophy, and total endplate scores (TEPS). Also, a strong and independent association between endplate HU value and LDD was found at every lumbar disc level (p < 0.01). After conditioning on matching factors, multivariate logistic regression analysis showed that higher endplate HU (odds ratio [OR]: 1.003, p = 0.003), higher TEPS (OR: 1.264, p = 0.002), higher BMI (odds ratio [OR]: 1.202, p = 0.002), a smaller cross‐sectional area (CSA) of the paraspinal muscle preoperatively (OR: 0.096, p < 0.001) were significant predictors of LDD development after TLIF surgery.
Conclusions
There is a significant association between LDD and endplate HU value after TLIF surgery in patients with degenerative lumbar stenosis. Beyond that, results from this study provide a mechanism by which high endplate HU value predisposes to LDD after TLIF surgery.
Measurement of the Hounsfield units (HU) values of endplate. Locating the endplate in the sagittal plane then trailing edge of hyperintense area and recording the mean HU value in the coronal plane.