Bone density of the cervical, thoracic and lumbar spine measured using Hounsfield units of computed tomography – results of 4350 vertebras

Abstract

Introduction The assessment of bone density has gained significance in recent years due to the aging population. Accurate assessment of bone density is crucial when deciding on the appropriate treatment plan for spinal stabilization surgery. The objective of this work was to determine the trabecular bone density values of the subaxial cervical, thoracic and lumbar spine using Hounsfield units. Material and Methods Data from 200 patients who underwent contrast-enhanced polytrauma computed tomography at a maximum care hospital over a two-year period were retrospectively analyzed. HUs were measured with an elliptical measurement field in three different locations within the vertebral body: below the upper plate, in the middle of the vertebral body, and above the base plate. The measured Hounsfield units were converted into bone density values using a validated formula. Results The mean age of the patient collective was 47.05 years. Mean spinal bone density values decreased from cranial to caudal (C3: 231.79 mg/cm³; L5: 155.13 mg/cm³; p < 0.001), with the highest values in the upper cervical spine. Bone density values generally decreased with age in all spinal segments. There was a clear decrease in values after age 50 years (p < 0.001). Conclusions In our study, bone density decreased from cranial to caudal with higher values in the cervical spine. These data from the individual spinal segments may be helpful to comprehensively evaluate the status of the spine and to design a better preoperative plan before instrumentation.

Lifestyle and Bone Health: Analyzing the Association Between LE8 Scores and BMD

“…Individuals within the normal BMI range (18.5-24.9) typically have better nutritional status and physical activity levels, which are bene cial for bone health. Studies indicate that these individuals are more likely to maintain adequate calcium and vitamin D intake, and moderate body weight exerts optimal pressure on bones, aiding in BMD maintenance [34] .Furthermore, the study observed a signi cant increase in thoracic spine BMD among females, potentially due to higher baseline thoracic BMD in males or differences in hormone levels, such as estrogen, which is known to signi cantly affect BMD in females [35] . Estrogen levels can in uence bone density, and healthy behaviors included in the LE8 score, such as physical activity and nutritional intake, may help maintain or increase estrogen levels, thereby enhancing BMD.The study did not nd a signi cant relationship between LE8 scores and head BMD [36] .…”