Comparison of cervical, thoracic, and lumbar vertebral bone quality scores for increased utility of bone mineral density screening

Razzouk, Jacob; Ramos, Omar; Ouro-Rodrigues, Evelyn; Samayoa, Carlos; Wycliffe, Nathaniel; Cheng, Wayne K.; Danisa, Olumide

doi:10.1007/s00586-022-07484-5

Cited by 19 publications

(9 citation statements)

References 36 publications

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“…The VBQ score measurement method was shown as previously report 20 . First, we placed the region of interest (ROI) in the medullary portions of C3 through C6 vertebral bodies to obtain the average signal intensity (SI).…”

Section: Methodsmentioning

confidence: 99%

“…The VBQ score measurement method was shown as previously report. 20 First, we placed the region of interest (ROI) in the medullary portions of C3 through C6 vertebral bodies to obtain the average signal intensity (SI). Then, the average SI was divided by the signal intensity of the cerebrospinal fluid (CSF) at the level of C5 to obtain the VBQ score.…”

Section: Mri-based Assessmentsmentioning

confidence: 99%

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The Association between High Preoperative MRI‐based Vertebral Bone Quality (VBQ) Score and Titanium Mesh Cage Subsidence after Anterior Cervical Corpectomy and Fusion

Li,

Zhu,

Xia

et al. 2023

Orthopaedic Surgery

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ObjectiveRecently, the MRI‐based vertebral bone quality (VBQ) score has been shown to correlate with Hounsfeld units (HU) value, dual‐energy X‐ray absorptiometry (DEXA) T‐score and predict osteoporotic fractures. Preoperative cervical HU value is an independent correlative factor for early titanium mesh cage (TMC) subsidence after anterior cervical corpectomy and fusion (ACCF). However, to date the direct association between cervical VBQ score and TMC subsidence has not been studied. This study aims to investigate the predictive effect of cervical VBQ score derived from sagittal non‐contrast‐enhanced T1‐weighted MRI on the early TMC subsidence after ACCF.MethodsPatients who underwent one‐level ACCF from January 2016 to January 2020 were included. We retrospectively collected baseline data on age, sex, body mass index (BMI), disease type, level of surgery and radiology parameters. The cervical VBQ score was measured using preoperative non‐contrast‐enhanced T1‐weighted MRI. Univariate and multivariate logistic regression analysis were performed to screen the independent risk factors of TMC subsidence. The receiver operating characteristic (ROC) curve and area under curve (AUC) were performed to assess the predictive ability of TMC subsidence based on the cervical VBQ score. Spearman correlation analysis was used to determine the correlations between the cervical VBQ score and TMC subsidence.ResultsA total of 134 patients who underwent one‐level ACCF were included in this study, and 46 (34.33%) patients had TMC subsidence. Univariable analyses demonstrated that the age, TMC placement depth and VBQ score were associated with subsidence. The cervical VBQ score in the subsidence group was significantly higher than that in the no subsidence group (3.75 ± 0.45 vs. 3.20 ± 0.42, p < 0.001). The multivariate logistic regression analysis proved that the higher VBQ score (odds ratio[OR] = 13.563, 95% confidence interval [CI] 4.968 ‐ 37.031, p < 0.001) was the only variable that significantly predicted subsidence. Using a VBQ score cutoff value of 3.445, the cervical VBQ score yielded a sensitivity of 69.6% and a specificity of 85.2% with an AUC of 0.810 to differentiate patients with subsidence and with no subsidence.ConclusionPreoperative higher cervical VBQ score is an independent risk factor for TMC subsidence after ACCF. The cervical VBQ score may be a valuable tool for assisting in distinguishing the presence of TMC subsidence.

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Section: Methodsmentioning

confidence: 99%

Section: Mri-based Assessmentsmentioning

confidence: 99%

The Association between High Preoperative MRI‐based Vertebral Bone Quality (VBQ) Score and Titanium Mesh Cage Subsidence after Anterior Cervical Corpectomy and Fusion

Li,

Zhu,

Xia

et al. 2023

Orthopaedic Surgery

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“…[17][18][19] Paired sample t tests were used to assess for statistically significant differences among PFR, CT, and MRI-derived neuroforaminal measurements. 19 Paired sample t tests were also used to assess for differences between left and right-sided neuroforaminal measurements. One-way analysis of variance with post hoc Bonferroni and Tukey corrections was used to assess differences among PFR, CT, and MRI-derived measurements across disc levels.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…[14][15][16] Correlation coefficients were categorized as weak, moderate, and strong corresponding to value ranges of 0 to 0.4, 0.4 to 0.7, and 0.7 to 1, respectively. [17][18][19] Paired sample t tests were used to assess for statistically significant differences among PFR, CT, and MRI-derived neuroforaminal measurements. 19 Paired sample t tests were also used to assess for differences between left and right-sided neuroforaminal measurements.…”

Section: Statistical Analysesmentioning

confidence: 99%

Normative Measurements of L1 to S1 Neuroforaminal Dimensions Derived From Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging

Razzouk,

Vyhmeister,

Carter

et al. 2023

Spine

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Study Design. retrospective cohort Objective. To report normative measurements of L1-S1 lumbar neuroforamina on plain film radiography (PFR), computed tomography (CT), and magnetic resonance imaging (MRI), accounting for patient sex and ethnicity. Summary of Background Data. Quantitative criteria for diagnosis of neuroforaminal stenosis (NFS) remains unknown. Acquiring a thorough understanding of normative foraminal dimensions is a key step in formulating objective parameters for NFS. Methods. We measured 988 images from 494 patients between 18 and 35 years-old without spinal pathology who received PFR, CT, or MRI within one year of each other. Neuroforaminal measurements were defined as the height, area, and sagittal and axial widths. Statistical analyses were performed to assess relationships among PFR-, CT-, and MRI-derived neuroforaminal measurements as well as the influence of patient sex and ethnicity. Results. 330 PFR, 377 CT, and 281 MRI were measured. Of these, 213 PFR and CT, 117 PFR and MRI, and 164 MRI and CT intrapatient images were compared. Statistically significant differences were observed among PFR, CT, and MRI measurements across all levels L1-S1. PFR measurements were larger compared to those derived from CT and MRI. Weak-to-moderate correlations were observed between PFR and CT, PFR and MRI, and CT and MRI, with the magnitude of correlation decreasing caudally from L1-S1. Variations in neuroforaminal anatomy were observed based on sex and ethnicity. Conclusion. This study reports 25,951 measurements of normal L1-S1 neuroforaminal anatomy assessed by PFR, CT, and MRI. The values reported in this study may be used as normative reference measurements of the lumbar neuroforamina. PFR measurements of the neuroforamina are larger compared to those derived from CT and MRI across all levels from L1-S1. There is poor correlation among PFR, CT and MRI when measuring the lumbar neuroforamina. Differences in neuroforaminal anatomy are evident based on patient sex and ethnicity.

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“…Recently, a novel method of determining MRI-based vertebral bone quality (VBQ) score was proposed for evaluating the quality and fat infiltration of trabecular bone [ 10 ]. This score was found to significantly correlate with BMD assessed using the DEXA scan, which may help reduce investigation costs and radiation hazards [ 11 , 12 ]. Moreover, the VBQ score has been recognized as an independent risk factor for fragility fractures, and it predicts the occurrence of cage subsidence and reoperation after transforaminal lumbar interbody fusion surgery [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Vertebral bone quality score to predict cage subsidence following oblique lumbar interbody fusion

et al. 2023

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Background Current evidence suggests that the magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score is a good parameter for evaluating bone quality. We aimed to assess whether the VBQ score can predict the occurrence of postoperative cage subsidence after oblique lumbar interbody fusion (OLIF) surgery. Methods Patients (n = 102) who had undergone single-level OLIF with a minimal follow-up for 1 year were reviewed in this study. Demographic and radiographic data of these patients were collected. Cage subsidence was defined as ≥ 2 mm of cage migration into the inferior endplate, superior endplate, or both. Further, the MRI-based VBQ score was measured on T1-weighted images. Moreover, univariable and multivariable binary logistic regression analyses were performed. Meanwhile, Pearson analysis was used to evaluate the correlation among the VBQ score, average lumbar dual-energy X-ray absorptiometry (DEXA) T-score, and degree of cage subsidence. Furthermore, ad-hoc analysis was used along with receiver operating characteristic curve analysis to assess the predictive ability of the VBQ score and average lumbar DEXA T-score. Results Of 102 participants, cage subsidence was observed in 39 (38.24%) patients. According to the univariable analysis, patients with subsidence had older age, higher antiosteoporotic drug use, larger disk height change, a more concave morphology of inferior and superior endplates, higher VBQ score, and lower average lumbar DEXA T-score compared to patients without subsidence. In the multivariable logistic regression analysis, a higher VBQ score was significantly associated with an increased risk of subsidence (OR = 23.158 ± 0.849, 95% CI 4.381–122.399, p < 0.001), and it was the only significant and independent predictor of subsidence after OLIF. Moreover, the VBQ score was moderately correlated with the average lumbar DEXA T-score (r = − 0.576, p < 0.001) and the amount of cage subsidence (r = 0.649, p < 0.001). Furthermore, this score significantly predicted cage subsidence with an accuracy of 83.9%. Conclusions The VBQ score can independently predict postoperative cage subsidence in patients undergoing OLIF surgery.

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Comparison of cervical, thoracic, and lumbar vertebral bone quality scores for increased utility of bone mineral density screening

Cited by 19 publications

References 36 publications

The Association between High Preoperative MRI‐based Vertebral Bone Quality (VBQ) Score and Titanium Mesh Cage Subsidence after Anterior Cervical Corpectomy and Fusion

The Association between High Preoperative MRI‐based Vertebral Bone Quality (VBQ) Score and Titanium Mesh Cage Subsidence after Anterior Cervical Corpectomy and Fusion

Normative Measurements of L1 to S1 Neuroforaminal Dimensions Derived From Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging

Vertebral bone quality score to predict cage subsidence following oblique lumbar interbody fusion

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