Prevalence of Osteoporosis in Patients Undergoing Lumbar Fusion for Lumbar Degenerative Diseases: A Combination of DXA and Hounsfield Units

Study Design. Retrospective analysis. Objective. To investigate the prevalence of osteoporosis (OP) in patients undergoing lumbar fusion for lumbar degenerative diseases (LDD). Summary of Background Data. OP is related to many complications after lumbar fusion for patients with LDD. There are sparse data on the prevalence of OP among this specific population. Moreover, LDD can falsely elevate the bone mineral density measured by dual energy x-ray absorptiometry (DXA), leading to unreliable diagnostic results. Computed tomography (CT) Hounsfield unit (HU) values can help identify osteoporotic patients undetected by DXA. Methods. A total of 479 patients aged≥50 years undergoing lumbar fusion for LDD were reviewed. The diagnosis of OP using DXA was based on World Health Organization criterion. The criterion for OP diagnosed on CT scan was the L1-HU value≤110. Results. The prevalence of OP diagnosed on lumbar DXA, hip DXA, and both was 32.4%, 19.6%, 39.7%, respectively. The females had higher prevalence of OP diagnosed on DXA (spine and hip) than males (48.9% vs. 27.1%, P 
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

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AbstractThe surgeon general of the USA defines osteoporosis as “a skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture.” Measuring bone strength,Biomechanical Computed Tomography analysis  (BCT), namely, finite element analysis of a patient’s clinical-resolution computed tomography (CT) scan, is now available in the USA as a Medicare screening benefit for osteoporosis diagnostic testing. Helping to address under-diagnosis of osteoporosis, BCT can be applied “opportunistically” to most existing CT scans that include the spine or hip re...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Conclusions: As NaF PET/CT becomes more popular in evaluating skeletal calcium metabolism (as shown by the measurement of osteoporosis), advancing technology such as total-body PET/CT scanners should be used to take complete advantage of this imaging modality. We believe that future, well-powered studies are needed to prove this prediction, and detail the far-reaching benefits today-body PET/CT scanners can have for osteoporotic patients.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Poster Session I Source Type: research
46Objectives: Traditionally, obesity is believed to be protective against osteoporosis. However, recent accumulating evidences suggest that visceral obesity increases the risk of osteoporosis and obesity-driven dysfunctional metabolic activity in visceral adipose tissue (VAT) is considered as a possible underlying mechanism for the development of obesity-related osteoporosis. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to assess the degree of VAT metabolic activity. We aimed to investigate the predictive role of VAT metabolic activity evaluated by 18F-FD...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Spotlights in Endocrinology Source Type: research
AbstractPurpose of ReviewThis review discusses imaging modalities for fracture repair assessment, with an emphasis on pragmatic clinical and translational use, best practices for implementation, and challenges and opportunities for continuing research.Recent FindingsSemiquantitative radiographic union scoring remains the clinical gold standard, but has questionable reliability as a surrogate indicator of structural bone healing, particularly in early-stage, complex, or compromised healing scenarios. Alternatively, computed tomography (CT) scanning enables quantitative assessment of callus morphometry and mechanics through ...
Source: Current Osteoporosis Reports - Category: Orthopaedics Source Type: research
This study aimed to determine the relationship of PMI to clinical parameters including bone mineral density (BMD) in candidates for lung transplantation.MethodsA retrospective review of transplant candidates at a single center was performed. Demographic, anthropomorphic, and clinical data were recorded. Pectoralis muscle area (PMA) was determined on an axial slice from a chest CT. PMI was calculated as the PMA divided by height squared. BMD was obtained from routine dual-energy X-ray absorptiometry (DXA) scan.ResultsIn 226 included patients, mean PMI was 8.2  ± 3.0 cm2/m2 in males and 6.1  ...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
AbstractSummaryWe performed a prospective study using both FRAX and computed tomography to screen for osteoporosis in men undergoing radiation for prostate cancer. We found that implementing routine computed tomography (CT)-based screening was feasible in the setting of a prospective study, but the yield of osteoporosis identification was low in this population.PurposeMen with prostate cancer (PCa) are at increased risk of hip fracture for multiple reasons. Estimation of hip fracture risk with the FRAX tool is currently recommended, but FRAX alone may not identify a portion of men with osteoporosis. We hypothesized that ad...
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
AbstractSummaryLumbar spine volumetric bone mineral density (BMD) measured using quantitative computed tomography (QCT) can discriminate between postmenopausal women with low areal BMD with and without vertebral fractures. QCT provides a 3D measure of BMD, excludes the vertebral posterior elements and accounts for bone size. This knowledge could contribute to effective treatment targeting of patients with low BMD.IntroductionWe evaluated the ability of lumbar spine bone mineral apparent density (BMAD), trabecular bone score (TBS) and volumetric bone mineral density (vBMD) to discriminate between postmenopausal women with l...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Patients at risk for osteoporotic fractures can be identified through their...Read more on AuntMinnie.comRelated Reading: AI accurately detects vertebral fractures on CT AAOS: QCT finds low bone density in lumbar fusion patients 3D DEXA enhances hip fracture risk prediction USPSTF reaffirms osteoporosis screening Vertebral CAD aces detection of compression fractures
Source: Headlines - Category: Radiology Source Type: news
ConclusionsHU measurements in CT scans have proven to be a feasible tool to additionally assess bone quality at the lumbar and sacral spine with good sensitivity, when compared with the gold standard DXA.Level of evidenceIII.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
ConclusionsThe newly developed 3D MOI enables distinguishing women with osteoporosis from those with normal BMD with good sensitivity and specificity.Clinical relevanceWhenever a CBCT scan is performed for specific clinical indications, a 3D MOI may be performed to qualitatively and quantitatively assess the condition of the mandibular cortex. This may be surely helpful to assess the osteoporosis status in the ageing population and more specifically in peri- or postmenopausal women.
Source: Clinical Oral Investigations - Category: Dentistry Source Type: research
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