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Efficacy of two opportunistic methods for screening osteoporosis in lumbar spine surgery patients

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Abstract

Purpose

Hounsfield unit (HU) measurements and vertebral bone quality (VBQ) scores are opportunistic screening methods for evaluating bone quality. Since studies comparing the efficacies of the two methods are rare, this retrospective study aimed to examine the efficacy of VBQ scores compared with that of HU measurements for diagnosing osteoporosis in lumbar spine surgery patients.

Methods

We selected patients who had undergone spinal surgery between January 2020 and May 2022 from our database. The VBQ scores based on magnetic resonance imaging (MRI) and HU measurements based on computed tomography (CT) were calculated. Correlation analysis of the dual-energy X-ray absorptiometry (DEXA) T score and study parameters was performed. The Delong test and decision curve analysis (DCA) were used to compare the efficacies of the two methods.

Results

We included 118 consecutive patients who underwent selective spinal surgery. The VBQ score and HU measurement were significantly correlated with the DEXA T score. Based on the Delong test, HU measurement predicted osteoporosis more effectively than the VBQ score did. The DCA revealed that the VBQ score performed better than the HU measurement did.

Conclusions

The calculation of VBQ scores is a novel opportunistic screening method for diagnosing osteoporosis; however, CT-based HU measurements outperform MRI-based VBQ scores. HU measurements can be used as a screening method when pre-operative CT scans are available.

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Availability of data and materials

Data available on request from the authors.

Code availability

Not applicable.

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Funding

This work was supported by Joint Funds for the innovation of science and Technology, Fujian province (Grant number: 2020Y9055).

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Authors and Affiliations

  1. Department of Neurosurgery, Fujian Medical University Union Hospital, No.29 Xinquan, Fuzhou City, 350001, Fujian Province, China

    Yan-Wei Jiang

  2. Fujian Medical University, Fuzhou City, 350001, Fujian Province, China

    Ting-Ting Xu, Xue-Ying Huang & Yan-Wei Jiang

Authors
  1. Ting-Ting Xu
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  2. Xue-Ying Huang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TTX, XYH and YJ. The first draft of the manuscript was written by YJ, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yan-Wei Jiang.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Institutional Review Board approval was obtained (approval no. 2021KJCX038).

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Written informed consent was not required for this study because this is a retrospective study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figure 1A and B.

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Xu, TT., Huang, XY. & Jiang, YW. Efficacy of two opportunistic methods for screening osteoporosis in lumbar spine surgery patients. Eur Spine J 32, 3912–3918 (2023). https://doi.org/10.1007/s00586-023-07938-4

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  • DOI: https://doi.org/10.1007/s00586-023-07938-4

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