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Evaluating Alternatives To Dual-Energy X-Ray Absorptiometry For Assessing Bone Quality In Patients Undergoing Spine Surgery – Lumbar Disc Replacement

The article compares and contrasts the use of dual-energy x-ray absorptiometry (DEXA), CT, and MRI in assessing lumbar bone quality and screening for osteoporosis/osteopenia. The study reviewed 426 candidates screened for lumbar disc replacement and compared their DEXA, CT, and MRI scans. The results showed that all three types of scans were correlated with each other, with CT being more strongly correlated with lumbar DEXA values. CT Hounsfield units (HUs) were also found to be more related to osteoporosis/osteopenia classification based on DEXA T-scores compared to MRI vertebral bone quality (VBQ) values. The article concludes that CT may be an alternative to DEXA for assessing VBQ in this patient population

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced day surgery hospital on Harley Street UK

Published article

CONCLUSIONS: These results demonstrate that CT HUs more closely correlate to DEXA scores than MRI VBQ in this population of patients undergoing surgery for symptomatic disc degeneration. Thus, CT may be an alternative to DEXA for assessing VBQ in this population.

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Abstract Objective: The purpose of this study was to compare and contrast lumbar bone quality and osteoporosis/osteopenia screening results via dual-energy x-ray absorptiometry (DEXA), CT, and MRI. Methods: A consecutive series of 426 candidates screened for lumbar disc replacement over a 5-year period beginning in 2018 was reviewed. Patients with a preoperative lumbar spine DEXA,

Abstract

Objective: The purpose of this study was to compare and contrast lumbar bone quality and osteoporosis/osteopenia screening results via dual-energy x-ray absorptiometry (DEXA), CT, and MRI.

Methods: A consecutive series of 426 candidates screened for lumbar disc replacement over a 5-year period beginning in 2018 was reviewed. Patients with a preoperative lumbar spine DEXA scan and a CT and/or MRI scan were included. The primary outcome measures included the bone mineral density (BMD) and osteoporosis or osteopenia classification from DEXA scans, Hounsfield units (HUs) for CT, and vertebral bone quality (VBQ) assessment for MRI. Patients were included if they had a DEXA scan within 1 year of an MRI or CT scan. DEXA BMD scores from composite or level-by-level reports were recorded. Asynchronous MRI and CT measurements were conducted using PACS. Interrater and intrarater reliability scores were generated for both CT and MRI measurements and ranged from 1.000 for MRI L1-4 scans to 0.683 for MRI VBQ.

Results: All 3 types of scans were statistically significantly correlated with one another; however, CT was more strongly correlated with the lumbar DEXA value (r = 0.439, p < 0.001). The correlation between MRI VBQ and DEXA was -0.103, (p < 0.045). The CT level-by-level measurements correlate with the corresponding level-by-level DEXA BMD values (correlation ranging from 0.531 to 0.289, p < 0.001 to p = 0.007). CT HU values were more strongly related to osteoporosis/osteopenia classification based on DEXA T-scores than were MRI VBQ values. Receiver operating characteristic analyses found that the area under the curve was 0.817 for CT and 0.539 for MRI.

Conclusions: These results demonstrate that CT HUs more closely correlate to DEXA scores than MRI VBQ in this population of patients undergoing surgery for symptomatic disc degeneration. Thus, CT may be an alternative to DEXA for assessing VBQ in this population.

Keywords: bone density; degenerative; diagnostic technique; imaging; lumbar spine.

The London Spine Unit : most experienced day surgery hospital on Harley Street UK

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Evaluating alternatives to dual-energy x-ray absorptiometry for assessing bone quality in patients undergoing spine surgery

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Abstract Objective: The purpose of this study was to compare and contrast lumbar bone quality and osteoporosis/osteopenia screening results via dual-energy x-ray absorptiometry (DEXA), CT, and MRI. Methods: A consecutive series of 426 candidates screened for lumbar disc replacement over a 5-year period beginning in 2018 was reviewed. Patients with a preoperative lumbar spine DEXA

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