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Assessing the utility of MRI-based vertebral bone quality (VBQ) for predicting lumbar pedicle screw loosening

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Abstract

Study Design

Retrospective cohort.

Objective

The purpose of this study is to assess the potential of utilizing the MRI-based vertebral bone quality (VBQ) score as a predictive tool for pedicle screw loosening (PSL) in patients who have undergone pedicle screw fixation and to identify risk factors associated with VBQ scores.

Methods

One hundred and sixteen patients who had undergone pedicle screw fixation between December 2019 and January 2021 and had more than a year of follow-up were divided into two groups of PSL and non-PSL. The radiological and clinical parameters investigated were age, gender, body mass index, the VBQ score, length of fusion and the DXA T-score.

Results

Of the 116 patients included in the study, 22 patients developed pedicle screw loosening after surgery (18.97%). VBQ score of PSL group was higher than the non-PSL group (3.61 ± 0.63 vs. 2. 86 ± 0.43, p < 0.001). According to logistic regression, PSL was independently linked with a higher VBQ score (OR = 3.555, 95% confidence interval [1.620–7.802], p < 0.005). The AUC of predicting screw loosening was 0.774 (p < 0.001) for VBQ score, and the best threshold was 3.055 (sensitivity, 81.8%; specificity, 71.3%). High VBQ score was associated with age (r (114) = 0.29, p = 0.002), while it was not negatively correlated with T-scores of each part.

Conclusion

VBQ score is an independent predictor of pedicle screw loosening, with higher scores indicating a greater risk. Our results showed that older patients and women had higher VBQ scores.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Author notes

  1. Yu Gao, Wu Ye and Xuhui Ge have contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China

    Yu Gao, Wu Ye, Xuhui Ge, Haofan Wang, Junjun Xiong, Yufeng Zhu, Zhuanghui Wang, Jiaxing Wang, Pengyu Tang & Weihua Cai

  2. Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China

    Wei Liu

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Contributions

YG involved in data curation, formal analysis, writing—original draft, and writing—review and editing. WY involved in data curation and writing—review and editing. XG involved in data curation and writing—review and editing. HW involved in software. JX involved in investigation. YZ involved in figure preparation. ZW involved in formal analysis. JW involved in software and validation. PT involved in investigation. WL involved in writing—review and editing, and methodology. WC involved in conceptualization and methodology.

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Correspondence to Wei Liu or Weihua Cai.

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Gao, Y., Ye, W., Ge, X. et al. Assessing the utility of MRI-based vertebral bone quality (VBQ) for predicting lumbar pedicle screw loosening. Eur Spine J 33, 289–297 (2024). https://doi.org/10.1007/s00586-023-08034-3

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