Trinity Medical Center I Dr. Marin Guentchev, MD, PhD

Imaging criteria for fusion after cervical surgery

Computed tomography (CT) is considered the gold standard for proving fusion (adhesion of two or more vertebrae) after anterior cervical discectomy. However, the criteria for diagnosing fusion are not clearly defined. In the prestigious magazine for spinal surgery, colleagues from Germany and the Netherlands analyzed the 9 CT criterion's diagnostic value for assessing the degree of fusion after cervical discectomy.

The authors performed a retrospective radiographic study in 44 patients. The data are also compared with intraoperative observations in revision surgery. Statistical analysis showed that of the nine parameters used to diagnose fusion, the vertebrae idiom's visual association in more than three sections in CT gives the highest sensitivity (100%) and specificity (58%) for the presence of fusion. Interestingly, the multivariate analysis showed that the accuracy of the prediction does not increase if several criteria for determining fusion are applied.

These are important results for assessing the condition of patients and deciding whether they need reoperation or not.

And this is the original work:

Martine W T van Bilsen, Christopher Ullrich, Luis Ferraris, Axel Hempfing, Wolfgang Hitzl, Michael Mayer, Heiko Koller. Diagnostic Accuracy of CT Scan-Based Criteria Compared With Surgical Exploration for the Analysis of Cervical Fusion and Nonunion. J Neurosurg Spine 2020 Mar 6; 1-7
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