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ORIGINAL RESEARCH article

Front. Surg.

Sec. Orthopedic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1637376

Impact of Factors on Treatment Outcomes in Cervical Degenerative Disc Disease: A Logistic Regression Analysis of Anterior Decompression and Interbody Fusion with BAK/C Technique

Provisionally accepted
Liang  HaoLiang Hao1*Aobo  ZhangAobo Zhang2Fengming  ZhaoFengming Zhao1Honglei  LiuHonglei Liu1Xiaoli  SunXiaoli Sun1
  • 1Third Hospital of Shijiazhuang, Shijiazhuang, China
  • 2The Second Hospital of Hebei Medical University, Shijiazhuang, China

The final, formatted version of the article will be published soon.

Objectives: To identify predictive prognostic factors through logistic regression analysis in patients with cervical degenerative disc disease (CDDD) undergoing anterior cervical discectomy and fusion (ACDF) combined with the Bagby and Kuslich (BAK/C) interbody fusion technique. Methods: This retrospective study included 80 patients treated with ACDF and BAK/C between January and December 2020, with a 3-year follow-up. Patients were stratified into a control group (favorable recovery, n=52) and an observation group (poor recovery, n=28) based on pain relief and neurological improvement. Radiological fusion rates and Japanese Orthopaedic Association (JOA) scores were evaluated. Multivariate logistic regression was performed to assess independent predictors of outcomes. Results: The control group exhibited significant JOA score improvement at the final follow-up (14.49 ± 0.25 vs. preoperative 10.74 ± 1.16, P < 0.001), while the observation group showed limited recovery (12.19 ± 0.32 vs. preoperative 11.15 ± 1.45, P < 0.001). The overall fusion rate was significantly higher in the control group (92.3% vs. 64.3%, P = 0.002). Multivariate analysis identified age ≥55 years (observation group: 62.35 ± 5.41 vs. control: 51.47 ± 6.37, P < 0.001), reduced bone mineral density (T-score: −2.1 ± 0.8 vs. −1.3 ± 0.6, P < 0.001), postoperative complications (46.4% vs. 13.5%, P = 0.003), and baseline disease severity as independent risk factors for poor outcomes (P < 0.05). The observation group demonstrated significantly higher pseudoarthrosis rates (35.7% vs. 9.6%, P = 0.003). Conclusion: Advanced age, low bone density, and postoperative complications critically compromise outcomes of ACDF with BAK/C fusion. Preoperative bone density optimization, judicious use of augmented multi-level fixation, and precision patient selection are pivotal for improving prognosis. These findings provide evidence-based insights for individualized clinical decision-making.

Keywords: Anterior cervical discectomy and fusion, BAK/C interbody fusion, cervical disc degenerative disease, Pseudoarthrosis, bone mineral density, Logistic regression analysis

Received: 29 May 2025; Accepted: 12 Aug 2025.

Copyright: © 2025 Hao, Zhang, Zhao, Liu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Liang Hao, Third Hospital of Shijiazhuang, Shijiazhuang, China

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