Hounsfield Unit Values as an Adjunct Diagnostic Tool: Investigating Its Relationship with Bone Mineral Density and Vertebral Bone Quality in Lumbar Degenerative Disease Patients

Hiyama, Akihiko; Sakai, Daisuke; Katoh, Hiroyuki; Sato, Masato; Watanabe, Masahiko

doi:10.1016/j.wneu.2024.01.013

World Neurosurgery

2024

DOI: 10.1016/j.wneu.2024.01.013

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Hounsfield Unit Values as an Adjunct Diagnostic Tool: Investigating Its Relationship with Bone Mineral Density and Vertebral Bone Quality in Lumbar Degenerative Disease Patients

Akihiko Hiyama,

Daisuke Sakai,

Hiroyuki Katoh

et al.

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2024

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Cited by 5 publications

References 33 publications

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Postoperative decrease in Hounsfield unit values at adjacent vertebrae after thoraco‐pelvic fusion as a risk factor of proximal junctional kyphosis

Tsuchiya,

Okano,

Dodo

et al. 2024

Journal Orthopaedic Research

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Proximal junctional kyphosis and failure is a common complication of adult spinal deformity surgery, with osteoporosis as a risk factor. This retrospective study investigated the influence of long thoracolumbar fusion with pelvic fixation on regional bone density of adjacent vertebrae (Hounsfield units on computed tomography) and evaluated the association between bone loss and the incidence of proximal junctional kyphosis and failure. Patients who underwent long thoracolumbar fusion (pelvis to T10 or above) or single‐level posterior lumbar interbody fusion (control group) between 2016 and 2022 were recruited. Routine computed tomography preoperatively and within 1–2 weeks postoperatively was performed. Postoperative changes in Hounsfield unit values in the vertebrae at one and two levels above the uppermost instrumented vertebrae (UIV + 1 and UIV + 2) were evaluated. Overall, 127 patients were recruited: 45 long fusion (age, 73.9 ± 5.6 years) and 82 proximal junctional kyphosis and failure (age, 72.5 ± 9.3 years). Postoperative computed tomography was performed at a median [interquartile range] of 3.0 [1.0–7.0] and 4.0 [1.0–7.0] days, respectively. In both groups, Hounsfield unit values at UIV + 2 were significantly decreased postoperatively. In the long‐fusion group, Hounsfield unit values at UIV + 1 and UIV + 2 were significantly lower in patients with proximal junctional kyphosis and failure (within 18 months postoperatively) than in those without proximal junctional kyphosis and failure. Proximal junctional kyphosis and failure and long thoraco‐pelvic fusion negatively affect regional Hounsfield unit values at adjacent levels immediately after surgery. Patients with subsequent proximal junctional kyphosis and failure show greater postoperative bone loss at adjacent levels than those without.

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Postoperative decrease in Hounsfield unit values at adjacent vertebrae after thoraco‐pelvic fusion as a risk factor of proximal junctional kyphosis

Tsuchiya,

Okano,

Dodo

et al. 2024

Journal Orthopaedic Research

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show abstract

Low bone mineral density: a primer for the spine surgeon

Raad,

Kim,

Durand

et al. 2024

Spine Deform

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Correlations among MRI-based cervical and thoracic vertebral bone quality score, CT-based Hounsfield Unit score, and DEXA t-score in assessment of bone mineral density

Razzouk,

Bouterse,

Shin

et al. 2024

Journal of Clinical Neuroscience

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Hounsfield Unit Values as an Adjunct Diagnostic Tool: Investigating Its Relationship with Bone Mineral Density and Vertebral Bone Quality in Lumbar Degenerative Disease Patients

Cited by 5 publications

References 33 publications

Postoperative decrease in Hounsfield unit values at adjacent vertebrae after thoraco‐pelvic fusion as a risk factor of proximal junctional kyphosis

Postoperative decrease in Hounsfield unit values at adjacent vertebrae after thoraco‐pelvic fusion as a risk factor of proximal junctional kyphosis

Low bone mineral density: a primer for the spine surgeon

Correlations among MRI-based cervical and thoracic vertebral bone quality score, CT-based Hounsfield Unit score, and DEXA t-score in assessment of bone mineral density

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