99. Radiographic assessment of fusion: a comparison of interbody spacers, following anterior cervical decompression and fusion

• Published in: The spine journal 2020-09, Vol.20 (9), p.S49-S50
• Main Authors: Bennett, Tianna, Weissmann, Karen, Lafage, Renaud, Elysee, Jonathan, Alshabab, Basel Sheikh, Lafage, Virginie, Huang, Russel C., Kim, Han Jo, Lebl, Darren R., Albert, Todd J.
• Format: Article
• Language: English
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2020.05.205

While fusion in the context of anterior cervical discectomy and fusion (ACDF) has been reported to be as high as 97% at 4 years postop, little is known about the bridging of trabecular bone, radiolucency and interspinous motion (ISM) as definitive criterion for assessing fusion on radiographic X-ray imaging. While there is no conclusive method for quantifying interbody fusion (IBF), there is curiosity about whether these parameters can prove a spacer type to have a higher fusion rate than another. To determine whether the use of interbody cages (IC) promotes higher fusion rates in ACDF using plain X-ray studies. Single-center retrospective analysis of prospective consecutive database of multilevel ACDF. This study included 94 patients and 232 levels were evaluated with 1-year postop images from August 2015 to November 2018. Interspinous motion, bridging trabecular bone, fusion grade. A total of 32 published papers were reviewed to select the three best parameters for assessing cervical fusion: the passage of trabecula through the implant, the presence of a radiolucent line interfacing implant and vertebral plate, and the range of motion between two adjacent spinous processes. Radiolucency and bridging trabecular bone (BTB) parameters were combined to categorize each ACDF level as fused (≥75% BTB present) or not fused (