Scientific Reports (Jan 2023)

CT Hounsfield unit is a reliable parameter for screws loosening or cages subsidence in minimally invasive transforaminal lumbar interbody fusion

  • Yu-Cheng Yao,
  • Hsien Chao,
  • Kun-Yu Kao,
  • Hsi-Hsien Lin,
  • Shih-Tien Wang,
  • Ming-Chau Chang,
  • Chien-Lin Liu,
  • Po-Hsin Chou

DOI
https://doi.org/10.1038/s41598-023-28555-7
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 9

Abstract

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Abstract Retrospective cohort study. To validate computed tomography (CT) radiodensity in Hounsfield units (HU) as a prognostic marker for pedicle screw loosening or cage subsidence in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). The retrospective study involved 198 patients treated with MI-TLIF. Screw loosening (SL), cage subsidence (CS), and fusion status were assessed by plain radiographs. The risk factors of SL and CS were identified using logistic regression. A total of 258 levels and 930 screws were analyzed. During a 2-year follow-up, 16.2% and 24.7% of patients had CS and SL respectively. The cut-off value of L1 HU for predicting SL or CS was 117. The L1 HU 25 were two independent risk factors that can be screened preoperatively for preventing SL or CS and lead to better management of patients undergoing MI-TLIF.