Analysis of Magnetic Resonance Imaging-Based Vertebral Bone Quality Scores in Patients with Degenerative Lumbar Scoliosis

Abstract

Background: Degenerative lumbar scoliosis (DLS) often causes various issues such as neural symptoms and osteoporosis (OP). Vertebral bone quality (VBQ) is a crucial factor that surgeons take into consider prior to surgery. However, little attention has been given to the use of VBQ in evaluating vertebral bone mass in DLS patients. The aim of this study was to investigate the ability of magnetic resonance imaging-based VBQ score to evaluate bone mass in patients with DLS and its ability to predict OP.

Methods: A total of 120 patients were enrolled and divided into the DLS and non-DLS groups. The VBQ scores of the L1-L4 vertebral bodies were measured in noncontrast T1-weighted imaging. Dual-energy X-ray absorptiometry (DXA) was used to assess osteoporotic status. Additionally, patients with DLS were divided into 2 groups: with vertebral rotatory subluxation (VRS) and without VRS. The VBQ scores, computed tomography (CT) values, and DXA indicators were compared between the DLS and non-DLS groups, and between VRS and non-VRS groups. VBQ was compared with the CT value, bone density, and T-score using the Pearson correlation coefficient. VBQ was obtained according to the non-DLS group and compared with the accuracy of diagnosing OP with DXA.

Results: The DLS group was significantly different from the non-DLS group in terms of the VBQ score (3.53 vs. 2.98), CT value (109.81 vs. 134.60), T score (-1.19 vs. -1.72), and bone mineral density value (1.04 vs. 0.94). The VRS group presented a larger Cobb angle, lower CT value, and higher VBQ score. The area under the curve of the VBQ score in the prediction of OP was 0.804, with a sensitivity of 68.4% and a specificity of 85.7%.

Conclusions: VBQ can reduce interference from degeneration and deformities and can be used as a complementary method for vertebral quality assessment.

Keywords: Degenerative lumbar scoliosis; Hounsfield units; MRI; Osteoporosis; Vertebral bone quality.