Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;32(5):1553-1560.
doi: 10.1007/s00586-023-07643-2. Epub 2023 Mar 19.

Use of MRI-based vertebral bone quality score (VBQ) of S1 body in bone mineral density assessment for patients with lumbar degenerative diseases

Weibo Huang #  1 , Zhaoyang Gong #  1 , Hongli Wang  1 , Chaojun Zheng  1 , Yu Chen  1 , Xinlei Xia  1 , Xiaosheng Ma  1 , Jianyuan Jiang  2
Affiliations

Use of MRI-based vertebral bone quality score (VBQ) of S1 body in bone mineral density assessment for patients with lumbar degenerative diseases

Weibo Huang et al. Eur Spine J. 2023 May.

Abstract

Purpose: To evaluate the use of the modified and simplified vertebral bone quality (VBQ) method based on T1-weighted MRI images of S1 vertebrae in assessing bone mineral density (BMD) for patients with lumbar degenerative diseases.

Methods: We reviewed the preoperative data of patients with lumbar degenerative diseases undergoing lumbar spine surgery between January 2019 and June 2022 with available non-contrast T1-weighted magnetic resonance imaging (MRI), computed tomography (CT) images and dual-energy X-ray absorptiometry (DEXA). S1 vertebral bone quality scores (S1 VBQ) and S1 CT Hounsfield units were measured with picture archiving and communication system (PACS). One-way ANOVA was applied to present the discrepancy between the S1 VBQ of patients with normal bone density (T-score ≥ - 1.0), osteopenia (- 2.5 < T-score < - 1.0) and osteoporosis (T-score ≤ - 2.5). The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic performance of S1 VBQ in distinguishing low BMD. Statistical significance was set at p < 0.05.

Results: A total of 207 patients were included. The S1 VBQ were significantly different between groups (p < 0.001). Interclass correlation coefficient for inter-rater reliability was 0.86 (95% CI 0.78-0.94) and 0.94(95% CI 0.89-0.98) for intra-rater reliability. According to the linear regression analysis, the S1 VBQ has moderate-to-strong correlations with DEXA T-score (r = - 0.48, p < 0.001). The area under the ROC curve indicated a predictive accuracy of 82%. A sensitivity of 77.25% with a specificity of 70% could be achieved for distinguishing low BMD by setting the S1 VBQ cutoff as 2.93.

Conclusions: The S1 VBQ was a promising tool in distinguishing poor bone quality in patients with lumbar degenerative diseases, especially in cases where the previously reported VBQ method based on L1-L4 was not available. S1 VBQ score could be useful as opportunistic assessment for screening and complementary evaluation to DEXA T-score before surgery.

Keywords: Lumbar degenerative disease; Opportunistic screening; Osteoporosis; Vertebral bone quality score.

PubMed Disclaimer

References

    1. Sabnis AB, Chamoli U, Diwan AD (2018) Is L5–S1 motion segment different from the rest? A radiographic kinematic assessment of 72 patients with chronic low back pain. Eur Spine J 27:1127–1135. https://doi.org/10.1007/s00586-017-5400-4 - DOI - PubMed
    1. Pihlajämaki H, Myllynen P, Böstman O (1997) Complications of transpedicular lumbosacral fixation for non-traumatic disorders. J Bone Joint Surg Br Vol 79:183–189. https://doi.org/10.1302/0301-620x.79b2.7224 - DOI
    1. Niu CC, Chen WJ, Chen LH, Shih CH (1996) Reduction-fixation spinal system in spondylolisthesis. Am J Orthop (Belle Mead NJ) 25:418–424 - PubMed
    1. Soini J, Laine T, Pohjolainen T, Hurri H, Alaranta H (1993) Spondylodesis augmented by transpedicular fixation in the treatment of olisthetic and degenerative conditions of the lumbar spine. Clin Orthop Relat Res 297:111–116 - DOI
    1. Zhuang XM, Yu BS, Zheng ZM, Zhang JF, Lu WW (2010) Effect of the degree of osteoporosis on the biomechanical anchoring strength of the sacral pedicle screws: an in vitro comparison between unaugmented bicortical screws and polymethylmethacrylate augmented unicortical screws. Spine 35:E925-931. https://doi.org/10.1097/BRS.0b013e3181c5fb21 - DOI - PubMed

Publication types

LinkOut - more resources