Comparison of predictive performance for cage subsidence between CT-based Hounsfield units and MRI-based vertebral bone quality score following oblique lumbar interbody fusion

Pu, Xingxiao; Wang, Xiandi; Ran, Liyu; Xie, Tianhang; Li, Zhuhai; Yang, Zhiqiang; Lin, Run

doi:10.1007/s00330-023-09929-x

Cited by 9 publications

(3 citation statements)

References 25 publications

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“…Using Pearson’s correlation analysis, it was found that there was a negative correlation between T12VBQ and T-value, i.e., the higher the T12VBQ value, the worse the bone quality of the patient. The correlation between T12HU and T-values was greater than the correlation between T12VBQ and T-values, suggesting that HU is superior to VBQ, which is consistent with previous studies [ 7 , 25 , 26 ]. This may be because CT directly assesses the quality of bone trabeculae, whereas VBQ indirectly assesses bone density by measuring the signal intensity of fat.…”

Section: Discussionsupporting

confidence: 92%

“…Some patients are in need of lumbar spinal stenosis fusion surgery [ 6 ]. Osteoporosis was found to be a risk factor for cage settlement after lumbar fusion [ 7 ] and one of the main risk factors for pedicle screw loosening [ 8 ]. Therefore, early identification of patients with bone abnormalities facilitates the optimization of the choice of surgical approach and postoperative care, and reduces the incidence of associated complications.…”

Section: Introductionmentioning

confidence: 99%

“…The study found a significant correlation between VBQ and BMD [ 16 ]. Many researchers have used VBQ as an indicator to assess cage subsidence and recurrence after lumbar fusion surgery [ 7 , 17 ]. However, deformities, fractures, hemangiomas and local infections of the lumbar spine may affect the L1-4VBQ score.…”

Section: Introductionmentioning

confidence: 99%

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Opportunistic prediction of osteoporosis in patients with degenerative lumbar diseases: a simplified T12 vertebral bone quality approach

Xue,

Lu,

Sun

et al. 2024

J Orthop Surg Res

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Background Osteoporosis is one of the risk factors for screw loosening after lumbar fusion. However, the probability of preoperative osteoporosis screening in patients with lumbar degenerative disease is low. Therefore, the aim of this study was to investigate whether a simplified vertebral bone quality (VBQ) score based on T12 T1-MRI could opportunistically predict osteoporosis in patients with degenerative lumbar spine diseases. Methods We retrospectively analyzed cases treated for lumbar degenerative diseases at a single institution between August 2021 and June 2022. The patients were divided into three groups by the lowest T-score: osteoporosis group, osteopenia group, and normal bone mineral density (BMD) group. The signal intensity based on the T12 vertebral body divided by the signal intensity of the cerebrospinal fluid was calculated to obtain the simplified VBQ score, as well as the CT-based T12HU value and the traditional L1-4VBQ score. Various statistical analyses were used to compare VBQ, HU and DEXA, and the optimal T12VBQ threshold for predicting osteoporosis was obtained by plotting the receiver operating curve (ROC) analysis. Results Total of 166 patients were included in this study. There was a statistically significant difference in T12VBQ scores between the three groups (p < 0.001). Pearson correlation showed that there was a moderate correlation between T12VBQ and T-score (r=-0.406, p < 0.001). The AUC value of T12VBQ, which distinguishes between normal and low BMD, was 0.756, and the optimal diagnostic threshold was 2.94. The AUC value of T12VBQ, which distinguishes osteoporosis from non-osteoporosis, was 0.634, and the optimal diagnostic threshold was 3.18. Conclusion T12VBQ can be used as an effective opportunistic screening method for osteoporosis in patients with lumbar degenerative diseases. It can be used as a supplement to the evaluation of DEXA and preoperative evaluation. Trial registration retrospectively registered number:1502-009-644; retrospectively registered number date:27 oct 2022.

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Section: Discussionsupporting

confidence: 92%