The impact of degenerative disc disease on regional volumetric bone mineral density (vBMD) measured by quantitative computed tomography

Okano, Ichiro; Salzmann, Stephan N.; Jones, Conor; Miller, Courtney Ortiz; Shirahata, Toshiyuki; Rentenberger, Colleen; Shue, Jennifer; Carrino, John A.; Sama, Andrew A.; Cammisa, Frank P.; Girardi, Federico P.; Hughes, Alexander P.

doi:10.1016/j.spinee.2019.02.017

Cited by 23 publications

(15 citation statements)

References 52 publications

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“…With respect to other variables associated with BMD, similar to other reports we found lower BMD in older patients and greater BMD in patients with DM [14,20,21]. The latter observation is attributable to reduced bone turnover [20].…”

supporting

confidence: 90%

“…Effects of other conditions are inconclusive. For example, BMD is higher for patients with diabetes mellitus (DM), potentially due to decreased bone turnover [13,14]. In addition, causes of LDS such as facet joint displacement, ligament and muscle instability, and disc degeneration may be amplified by spinopelvic malalignment, weight-bearing on displaced vertebrae, and worse bone quality [9,15,19,21,24].…”

Section: Introductionmentioning

confidence: 99%

“…However, recent qCT studies show variations with BMD decreasing from L1 to L3 and then increasing from L4 to S1 [5,17]. Lower BMD is also associated with older age, smoking, physical inactivity, and use of corticosteroids, including those administered by epidural injection [14,18]. Effects of other conditions are inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative CT for Preoperative Assessment of Lumbar Degenerative Spondylolisthesis: The Unique Impact of L4 Bone Mineral Density on Single-Level Disease

Duculan

Fong

Carrino

et al. 2022

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Quantitative computed tomography (qCT) efficiently measures 3-dimensional vertebral bone mineral density (BMD), but its utility in measuring BMD at various vertebral levels in patients with lumbar degenerative spondylolisthesis (LDS) is unclear. Purpose: We sought to determine whether qCT could differentiate BMD at different levels of LDS, particularly at L4-L5, the most common single level for LDS. In addition, we sought to describe patterns of BMD for single-level and multiple-level LDS. Methods: We conducted a study of patients undergoing surgery for LDS who were part of a larger longitudinal study comparing preoperative and intraoperative images. Preoperative patients were grouped as single-level or multiple-level LDS, and qCT BMD was obtained for L1-S1 vertebrae. Mean BMD was compared with literature reports; in multivariable analyses, BMD of each vertebra was assessed according to the level of LDS, controlling for covariates and for BMD of other vertebrae. Results: Of 250 patients (mean age: 67 years, 64% women), 22 had LDS at L3-L4 only, 170 at L4-L5 only, 13 at L5-S1 only, and 45 at multiple levels. Compared with other disorders reported in the literature, BMD in our sample similarly decreased from L1 to L3 then increased from L4 to S1, but mean BMD per vertebra in our sample was lower. Nearly half of our sample met criteria for osteopenia. In multivariable analysis controlling for BMD at other vertebrae, lower L4 BMD was associated with LDS at L4-L5, greater pelvic incidence minus lumbar lordosis, and not having diabetes. In contrast, in similar multivariable analysis, greater L4 BMD was associated with LDS at L3-L4. Bone mineral density of L3 and L5 was not associated with LDS levels. Conclusion: In our sample of preoperative patients with LDS, we observed lower BMD for LDS than for other lumbar disorders. L4 BMD varied according to the level of LDS after controlling for covariates and BMD of other vertebrae. Given that BMD can be obtained from routine imaging, our findings suggest that qCT data may be useful in the comprehensive assessment of and strategy for LDS surgery. More research is needed to elucidate the cause-effect relationships among spinopelvic alignment, LDS, and BMD.

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confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Quantitative CT for Preoperative Assessment of Lumbar Degenerative Spondylolisthesis: The Unique Impact of L4 Bone Mineral Density on Single-Level Disease

Duculan

Fong

Carrino

et al. 2022

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

Self Cite

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“… 13 , 14 , 32 , 33 Quantitative CT (QCT) was introduced as a reliable method of assessing the bone quality with trabecular BMD instead of areal BMD measured by DXA. 34 However, it cannot be performed routinely in most hospitals due to patients’ unwillingness to undergo additional examinations. Zou et al introduced the HU system as a practical measurement tool utilizing lumbar CT to evaluate bone mineral density in patients with DDD without any extra cost.…”

Section: Discussionmentioning

confidence: 99%

Osteoporosis and Endplate Damage Correlation Using a Combined Approach of Hounsfield Unit Values and Total Endplate Scores: A Retrospective Cross-Sectional Study

Chen¹,

Wang²,

Chen³

et al. 2021

CIA

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Osteoporosis and endplate damage, two primary orthopedic disorders that have adverse effects on the quality of life of older adults, may have some previously unknown relationship. The purpose of this study was to determine the potential association between osteoporosis and endplate damage with two specific imaging scoring systems and analyze the underlying mechanisms. Patients and Methods: A cross-sectional study including 156 patients with degenerative disc disease (DDD) who visited our department in 2018 was performed. Data including age, sex, body mass index, Hounsfield unit (HU) values utilizing computed tomography (CT), and total endplate scores (TEPSs) using magnetic resonance imaging (MRI) of all patients were retrospectively collected and analyzed. The average HU value and TEPS of L1-L4 were used to represent the degrees of bone mineral density (BMD) and endplate damage, respectively. Patients with an HU value < 110 were defined as having osteoporosis and placed in the low-BMD group; otherwise, they were placed in the normal-BMD group. Multivariate logistic regression models were used to determine the independent factors of endplate damage. Results: The TEPSs in the low-BMD group were significantly higher (6.4 ± 1.6 vs 5.0 ± 0.9, p < 0.001) overall and in every segment of L1-L4 (p < 0.01). A significant negative correlation was found between TEPS and HU values (p < 0.001). The HU value (odds ratio [OR] 0.221; 95% confidence interval [CI], 0.148-0.295, p < 0.001), age (OR 0.047; 95% CI, 0.029-0.224, p < 0.001), and BMD (OR 3.796; 95% CI, 2.11-7.382, p < 0.05) were independent factors influencing endplate damage. Conclusion: A significantly positive correlation was observed between osteoporosis and endplate damage, indicating the requirement for a more comprehensive therapeutic regimen for treating patients with DDD complicated with osteoporosis.

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“…Traditional open surgery has a good surgical field of vision. Open surgery can make nerve decompression more thorough and have better and reliable surgical results [ 6 , 7 ].…”

Section: Related Theoretical Overview and Researchmentioning

confidence: 99%

Single-Segment Lumbar Intervertebral Disc Nucleus Excision on the Stability of Lumbar Segmental Sagittal Plane

Zhang

Huang

et al. 2022

Computational and Mathematical Methods in Medicine

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At present, lumbar disc herniation has become a problem that plagues people’s health, life safety, and social and economic development. Among them, the research of lumbar disc nucleus pulposus tissue is the focus of the treatment of lumbar disc diseases. At present, the treatment methods of lumbar disc herniation are divided into conservative treatment and surgical treatment, among which surgical treatment can be divided into open surgery and minimally invasive surgery. Surgical treatment to remove the nucleus pulposus from the disc by fenestration includes conventional ablation of the nucleus pulposus and microscopic lumbar discs. This treatment is effective, but it has a great impact on the stabilization mechanism of the spine, with large soft tissue damage and large blood loss, which can easily cause nerve damage and postdural adhesions. At the same time, single-segment lumbar discectomy has also been gradually applied to the treatment of this disease. Under this, this paper studies single-segment lumbar disc nucleus pulposus resection. The lumbar nucleus resection is performed in a single segment in the physiological load area, which can greatly ensure the stability of the sagittal plane of the lumbar spine. In order to better understand the postoperative rehabilitation and clinical effects of single-segment lumbar discectomy, as well as the changes in the sagittal plane of the lumbar vertebrae before and after the operation, so as to provide a reference for further improving the quality of life of patients, this paper uses questionnaire survey and data analysis methods. According to the results of the questionnaire survey, compared with other operations, single-segment lumbar discectomy is more stable in the sagittal plane of the lumbar spine within the physiological load range, and there is less displacement. The displacement may be caused or influenced by different kinds of factors such as heavy loads or manual labor. In addition, most patients have less abnormal pain after surgery, indicating that the surgery has a certain effect on the treatment of the disease, and there are fewer abnormalities after surgery.

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The impact of degenerative disc disease on regional volumetric bone mineral density (vBMD) measured by quantitative computed tomography

Cited by 23 publications

References 52 publications

Quantitative CT for Preoperative Assessment of Lumbar Degenerative Spondylolisthesis: The Unique Impact of L4 Bone Mineral Density on Single-Level Disease

Quantitative CT for Preoperative Assessment of Lumbar Degenerative Spondylolisthesis: The Unique Impact of L4 Bone Mineral Density on Single-Level Disease

Osteoporosis and Endplate Damage Correlation Using a Combined Approach of Hounsfield Unit Values and Total Endplate Scores: A Retrospective Cross-Sectional Study

Single-Segment Lumbar Intervertebral Disc Nucleus Excision on the Stability of Lumbar Segmental Sagittal Plane

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