Hounsfield units value is a better predictor of pedicle screw loosening than the T-score of DXA in patients with lumbar degenerative diseases

AbstractPurposeTo compare the performance of using Hounsfield units (HU) value derived from computed tomography and T-score of dual-energy X-ray absorptiometry (DXA) to predict pedicle screw loosening.MethodsWe reviewed 253 patients aged  ≥ 50 years undergoing pedicle screw fixation for lumbar degenerative diseases (LDD). The evaluation of screw loosening: radiolucent zones of ≥ 1 mm thick in X-ray. The criterion for osteoporosis: the lowest T-score ≤ − 2.5. The average HU value of L1–L4 was used to represe nt lumbar bone mineral density (BMD). The area under receiver operating characteristics curve (AUC) was used to evaluate the performance of predicting screw loosening.ResultsOne patient underwent reoperation for screw loosening at 9  months follow-up. At 12 months follow-up, the loosening rate was 30.6% (77/252) in the remaining 252 patients. Osteoporotic patients had higher loosening rate than non-osteoporotic patients (39.3% vs. 25.8%,P = 0.026). The T-score showed no significant difference between loosening group and non-loosening group (− 2.1 ± 1.5 vs. − 1.7 ± 1.6,P = 0.074), and so is the lowest lumbar BMD of DXA (0.83 ± 0.16 g/cm2 vs. 0.88  ± 0.19 g/cm2,P = 0.054). The HU value was lower in the loosening group (106.8&th...
Source: European Spine Journal - Category: Orthopaedics 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
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
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 ...
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY 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
Objective: Immunological abnormalities, the resulting endocrinopathies and their treatments may impact bone health in patients with autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED, APS1). The aim of the present study was to describe skeletal characteristics in patients with APECED and the prevalence and risk factors of compromised bone health.Patients and methods: We performed a cross-sectional study on 44 patients (27 females) with APECED and 82 age-, gender- and ethnicity-matched control subjects (54 females). We determined the prevalence of osteoporosis by dual-energy X-ray absorptiome...
Source: Frontiers in Endocrinology - Category: Endocrinology 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
AbstractObjectivesTo investigate whether a deep learning model can predict the bone mineral density (BMD) of lumbar vertebrae from unenhanced abdominal computed tomography (CT) images.MethodsIn this Institutional Review Board –approved retrospective study, patients who received both unenhanced CT examinations and dual-energy X-ray absorptiometry (DXA) of the lumbar vertebrae, in two institutions (1 and 2), were included. Supervised deep learning was employed to obtain a convolutional neural network (CNN) model using ax ial CT images, including the lumbar vertebrae as input data and BMD values obtained with DXA as ref...
Source: European Radiology - Category: Radiology 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: AuntMinnie.com Headlines - Category: Radiology Source Type: news
AbstractHereditary hemochromatosis (HHC) is characterized by excessive intestinal iron absorption resulting in a pathological increase of iron levels. Parenchyma damage may be a consequence of iron deposition in affected organs (e.g., liver, pancreas, gonads) as well as bones and joints, leading to osteoporosis with increased fracture risk and arthropathy. Up to date, it is not known whether HHC can also be considered as a risk factor for osteonecrosis. Likewise, the underlying skeletal changes are unknown regarding, e.g., microstructural properties of bone. We aimed to study the spectrum of skeletal complications in HHC a...
Source: Calcified Tissue International - Category: Orthopaedics Source Type: research
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