Vertebral bone quality score as a new tool for osteoporosis diagnosis in patients undergoing lumbosacral fusion surgery: a single center cohort study

Submitted: 25 January 2024
Accepted: 21 June 2024
Published: 16 September 2024
Abstract Views: 58
PDF: 22
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Osteoporosis, a common bone disorder, increases fracture and spinal surgery complications risk. This study evaluates the potential of the Magnetic Resonance Imaging (MRI)-based Vertebral Bone Quality (VBQ) score as an alternative for assessing bone density in lumbosacral fusion surgery patients. In a prospective cohort study from April 2021 to November 2022, 134 patients with lumbar degenerative diseases underwent lumbar Dual-Energy X-ray Absorptiometry (DXA) and lumbosacral non-contrast T1-weighted MRI. VBQ scores were calculated and analyzed using IBM SPSS Statistics and MedCalc software. Osteopenia/Osteoporosis patients exhibited significantly higher VBQ scores than normal bone mineral density patients (3.37 ± 0.51 vs. 2.99 ± 0.44, P<0.001). VBQ correlated significantly with lumbar DXA T scores (r value= -0.415, p<0.001). Receiver Operating Characteristic (ROC) analysis showed VBQ AUC values of 0.730 (CI 95% 0.647-0.803, P<0.001) and 0.839 (CI 95% 0.765-0.897, P<0.001) for Osteopenia/Osteoporosis and osteoporosis diagnosis, respectively. The study suggests MRI-derived VBQ scores may benefit pre-lumbosacral fusion surgery bone density assessment, potentially improving patient care and aiding osteoporosis detection in spinal surgery candidates.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Plaudit

Aibar-Almazán A, Voltes-Martínez A, Castellote-Caballero Y, et al. Current status of the diagnosis and management of osteoporosis. Int J Molecular Sci 2022;23:9465. DOI: https://doi.org/10.3390/ijms23169465
Nowakowska-Płaza A, Wroński J, Płaza M, et al. Diagnostic agreement between radiofrequency echographic multispectrometry and dual-energy X-ray absorptiometry in the assessment of osteoporosis in a Polish group of patients. Polish Arch Intern Med (Polskie Archiwum Medycyny Wewnetrznej) 2021;131:840-7. DOI: https://doi.org/10.20452/pamw.16046
Alawi M, Begum A, Harraz M, et al. Dual-energy X-ray absorptiometry (DEXA) scan versus computed tomography for bone density assessment. Cureus 2021;13. DOI: https://doi.org/10.7759/cureus.13261
Lane NE. Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstetr Gynecol 2006;194:S3-S11. DOI: https://doi.org/10.1016/j.ajog.2005.08.047
Chang E, Nickel B, Binkley N, et al. A novel osteoporosis screening protocol to identify orthopedic surgery patients for preoperative bone health optimization. Geriatric Orthop Surg Rehabil 2022;13:21514593221116413. DOI: https://doi.org/10.1177/21514593221116413
Mugge L, DeBacker Dang D, Caras A, et al. Osteoporosis as a risk factor for intraoperative complications and long-term instrumentation failure in patients with scoliotic spinal deformity. Spine 2022;47:1435-42. DOI: https://doi.org/10.1097/BRS.0000000000004418
Fathima SN, Selvi RT, Beham MP. Assessment of BMD and Statistical Analysis for Osteoporosis Detection. Biomed Pharmacol J 2019;12:1907-14. DOI: https://doi.org/10.13005/bpj/1822
Ginsberg C, Ix JH. Diagnosis and management of osteoporosis in advanced kidney disease: a review. Am J Kidney Dis 2022;79:427-36. DOI: https://doi.org/10.1053/j.ajkd.2021.06.031
Shayganfar A, Khodayi M, Ebrahimian S, Tabrizi Z. Quantitative diagnosis of osteoporosis using lumbar spine signal intensity in magnetic resonance imaging. Br J Radiol 2019;92:20180774. DOI: https://doi.org/10.1259/bjr.20180774
Ehresman J, Pennington Z, Schilling A, et al. Novel MRI-based score for assessment of bone density in operative spine patients. Spine J 2020;20:556-62. DOI: https://doi.org/10.1016/j.spinee.2019.10.018
Ehresman J, Ahmed AK, Lubelski D, et al. Vertebral bone quality score and postoperative lumbar lordosis associated with need for reoperation after lumbar fusion. World Neurosurg 2020;140:e247-e52. DOI: https://doi.org/10.1016/j.wneu.2020.05.020
Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol 2017;4:46. DOI: https://doi.org/10.5152/eurjrheum.2016.048
Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. Lancet 2011;377:1276-87. DOI: https://doi.org/10.1016/S0140-6736(10)62349-5
Lewiecki EM, Leader D, Weiss R, Williams SA. Challenges in osteoporosis awareness and management: results from a survey of US postmenopausal women. J Drug Assess 2019;8:25-31. DOI: https://doi.org/10.1080/21556660.2019.1579728
Soshi S, Shiba R, Kondo H, Murota K. An experimental study on transpedicular screw fixation in relation to osteoporosis of the lumbar spine. Spine 1991;16:1335-41. DOI: https://doi.org/10.1097/00007632-199111000-00015
Halvorson TL, Kelley LA, Thomas KA, et al. Effects of bone mineral density on pedicle screw fixation. Spine 1994;19:2415-20. DOI: https://doi.org/10.1097/00007632-199411000-00008
Dell R, Greene D. Is osteoporosis disease management cost effective? Curr Osteop Rep 2010;8:49-55. DOI: https://doi.org/10.1007/s11914-010-0009-0
Pu M, Zhong W, Heng H, et al. Vertebral bone quality score provides preoperative bone density assessment for patients undergoing lumbar spine surgery: a retrospective study. J Neurosurg Spine 2023;1:1-10. DOI: https://doi.org/10.3171/2023.1.SPINE221187
Ahmad A, Crawford CH, 3rd, Glassman SD, et al. Correlation between bone density measurements on CT or MRI versus DEXA scan: A systematic review. N Am Spine Soc J 2023;14:100204. DOI: https://doi.org/10.1016/j.xnsj.2023.100204
Salzmann SN, Okano I, Jones C, Zhu J, Lu S, Onyekwere I, et al. Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion. Spine J 2022;22:1301-8. DOI: https://doi.org/10.1016/j.spinee.2022.03.006
Chen Z, Lei F, Ye F, et al. MRI-based vertebral bone quality score for the assessment of osteoporosis in patients undergoing surgery for lumbar degenerative diseases. J Orthop Surg Res 2023;18:257. DOI: https://doi.org/10.1186/s13018-023-03746-0
Kim AYE, Lyons K, Sarmiento M, et al. MRI-Based Score for Assessment of Bone Mineral Density in Operative Spine Patients. Spine (Phila Pa 1976) 2023;48:107-12. DOI: https://doi.org/10.1097/BRS.0000000000004509
Yang D-d, Li Y, Tian J-y, et al. MRI-based vertebral bone quality score as a novel bone status marker of patients with adolescent idiopathic scoliosis. Sci Rep 2024;14:12518. DOI: https://doi.org/10.1038/s41598-024-63426-9

How to Cite

Najafi, A., Baradaran Bagheri, A., Hadavi, D., Mobedi, A., Azarsina, S., & Chaghamirzayi, P. (2024). Vertebral bone quality score as a new tool for osteoporosis diagnosis in patients undergoing lumbosacral fusion surgery: a single center cohort study. European Journal of Translational Myology. https://doi.org/10.4081/ejtm.2024.12311