Discordantly High Spinal Bone Mineral Density Values in Patients With Adult Lumbar Scoliosis

Abstract

Cobb's angle measurements on DEXA scans are reliable and comparable to conventional radiographs. Spinal BMD values are less valuable for monitoring osteoporosis than hip values in scoliotic patients; an increasing discrepancy with age was noted. Scoliotic patients exhibited discordantly high spinal BMD values, despite significant hip osteoporosis. The discrepancy correlated with aging and curve magnitude. Scoliosis was common among the osteoporotic population (9.47%). Lumbar scoliosis is a useful clinical marker for osteoporosis, irrespective of scoliosis history and magnitude. Viable alternatives for osteoporosis evaluation of adult patients with lumbar scoliosis are hip DEXA values, in conjunction with other BMD measurements.

Does hormone replacement therapy prevent lateral rotatory spondylolisthesis in postmenopausal women?

“…Scoliosis is more frequent in osteoporotic patients than in osteopenic patients [16]. Lumbar bone loss was still observed in scoliotic patients below 60 years of age, and deformity worsened after HRT withdrawal, but not when bisphosphonates were used [17].…”

“…Bone mineral density (BMD) is low at the hip site in adults with lumbar scoliosis [16]. However, the lumbar BMD is increased in scoliosis, and the increase occurs predominantly on the concave side, due to bone accretion, which probably depends on the mechanical loads applied [17].…”

The impact of lumbar scoliosis on pain, function and health-related quality of life in postmenopausal women

“…Our study utilized DXA as screening tool, which has the advantage of being an imaging tool routinely used in postmenopausal women to screen for bone mass loss, independent of the presence of symptoms. In addition, DXA scan imaging obtained in a supine position has proven to have an excellent correlation (0.91) with standing antero-posterior lumbar radiographs [28]; we also have shown an excellent intra-and interobserver correlation in measurement of the Cobb angle in DXA scan imaging [13]. However, DXA did not allow us to determine the presence of degenerative disc disease severity, or the presence of lateral listhesis; we did not have sagittal views of the lumbar spine either to establish the presence of spondylolisthesis or sagittal imbalance, factors that may influence symptoms.…”

Candidate gene analysis and exome sequencing confirm LBX1 as a susceptibility gene for idiopathic scoliosis

“…In both these cohorts, dual-energy X-ray absorptiometry (DXA) for studying bone density had been part of the research protocol. Dual-energy X-ray absorptiometry has been reported to be a reliable method to evaluate scoliosis, comparable to conventional radiographs [15]. However, DXA is performed with the patient in a supine position, and the Cobb angle may be underestimated compared with standing radiographs.…”