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The purpose of this study was to investigate the factors that affect the preoperative imaging characteristics of patients and their influence on poor neurologic recovery after anterior cervical discectomy and fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the clinical data of 89 patients who met the criteria for anterior cervical discectomy and fusion for the treatment of single-level cervical spondylotic myelopathy and evaluated the patients\u2019 neurological recovery based on the recovery rate of the Japanese Orthopaedic Association (JOA) scores at the time of the final follow-up visit. Patients were categorized into the \u201cgood\u201d and \u201cpoor\u201d groups based on the JOA recovery rates of \u2265\u200950% and &lt;\u200950%, respectively. Clinical information (age, gender, body mass index, duration of symptoms, preoperative JOA score, and JOA score at the final follow-up) and imaging characteristics (cervical kyphosis, cervical instability, ossification of the posterior longitudinal ligament (OPLL), calcification of herniated intervertebral discs, increased signal intensity (ISI) of the spinal cord on T2-weighted imaging (T2WI), and degree of degeneration of the discs adjacent to the fused levels (cranial and caudal) were collected from the patients. Univariate and binary logistic regression analyses were performed to identify risk factors for poor neurologic recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of the patients was 52.56\u2009\u00b1\u200911.18 years, and the mean follow-up was 26.89\u2009\u00b1\u200911.14 months. Twenty patients (22.5%) had poor neurological recovery. Univariate analysis showed that significant predictors of poor neurological recovery were age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), concomitant OPLL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), concomitant calcification of herniated intervertebral discs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), ISI of the spinal cord on T2WI (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05), a high grade of degeneration of the discs of the cranial neighboring levels (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05), and a high grade of discs of the caudal neighboring levels (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05). Binary logistic regression analysis showed that ISI of the spinal cord on T2WI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001 OR\u2009=\u200924.947) and high degree of degeneration of adjacent discs on the cranial side (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040 OR\u2009=\u20096.260) were independent risk factors for poor neurological prognosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ISI of the spinal cord on T2WI and high degree of cranial adjacent disc degeneration are independent risk factors for poor neurological recovery after anterior cervical discectomy and fusion. A comprehensive analysis of the patients\u2019 preoperative imaging characteristics can help in the development of surgical protocols and the management of patients\u2019 surgical expectations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-024-04886-7","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:02:08Z","timestamp":1720051328000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics"],"prefix":"10.1186","volume":"19","author":[{"given":"Haitao","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Chai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiubo","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,4]]},"reference":[{"issue":"1","key":"4886_CR1","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1186\/s13018-023-03640-9","volume":"18","author":"X Li","year":"2023","unstructured":"Li X, Wang Y, Zhu W, et al. 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