Preoperative Cervical Vertebral Bone Quality Score as a Predictor of Adjacent Segment Degeneration After Anterior Cervical Discectomy and Fusion: A Retrospective Study

OBJECTIVE: To evaluate the predictive efficacy of the preoperative Cervical Vertebral Bone Quality (C-VBQ) score for adjacent segment degeneration (ASD) following anterior cervical discectomy and fusion (ACDF). METHODS: This single-center retrospective study included patients with degenerative cervical spine disease who underwent ACDF (2019-2023). All patients had ≥24 months of clinical and radiological follow-up. Demographic, surgical, and radiological data were collected. Simple linear regression assessed correlations between baseline characteristics and C-VBQ score. C-VBQ score's predictive performance was evaluated via receiver operating characteristic curve analysis; multivariate logistic regression identified independent risk factors for ASD. RESULTS: A total of 121 patients met the inclusion criteria (mean age: 53±9 years; female proportion: 56.2%). Among these patients, 63 (52.1%) developed radiographic ASD, and 19 (15.7%) developed symptomatic ASD. A higher C-VBQ score was a significant predictor of radiographic ASD in univariate analysis (2.5 [2.2; 2.9] vs. 1.2 [0.9; 1.7]; P