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Purpose: The study aimed to examine the consistency of vertebral bone quality (VBQ) scores for assessing osteoporosis across different etiologies and explore the predictive value of various VBQ scores for fragility vertebral fractures., Methods: Patients with fragility fractures were matched by age and sex to patients with lumbar degeneration. VBQ scores were calculated in T1- and T2-weighted magnetic resonance imaging. Differential analysis of bone quality was performed based on etiology., Results: A total of 96 inpatients were retrospectively enrolled. VBQ T1 scores were only sensitive to osteoporotic bone in degenerative group (p < 0.01), failing to identify osteoporosis in fractured group (p > 0.05). For the degenerative group, the area under the curve (AUC) using the VBQ T1 scores to differentiate osteoporosis was 0.72. After controlling the confounding variables, only VBQ T2 scores were significantly higher in fractured group than degenerative group, with a greater AUC of 0.82 predicting fragility fractures. VBQ T1 scores moderately correlated with femoral neck T-scores in degenerative group (r = -0.45, p < 0.01) but not in fractured group (r = -0.24, p > 0.05). VBQ T2 scores were not associated with femoral neck T-scores (p > 0.05)., Conclusion: This study is the first to evaluate the effectiveness of VBQs scores in assessing osteoporosis post-fracture. Only non-fractured patients' bone quality is fully susceptible to VBQ T1 scores. While VBQ T1 scores may not correlate with fragility fractures, VBQ T2 scores present a viable alternative., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To identify the ideal entry point for pediatric C2 pedicle screw and to obtain parameters of it for the indication of pediatric atlantoaxial fusion arthrodesis., Methods: The pediatric cervical CT images were reconstructed into the 3D digital models and the C2 vertebrae were separated. The location of ideal entry point and screw placement related linear and angular parameters were assessed on the 3D digital models., Results: A total of 214 pedicles from 107 C2 digital models were analyzed. The average entry point for C2 was 3.80 ± 2.78 mm medial to the lateral notch (LN) and 2.57 ± 1.70 mm superior to the LN. The average pedicle diameter (PD) was 6.02 ± 1.31 mm, and the average pedicle screw length (PSL) was 25.63 ± 3.46 mm. Statistical differences were found between different sex for PD and PSL (P < 0.05). As patient age increases, using the most lateral and inferior edge of the lateral mass as a reference marker, the entry point tends to move medial and cephalad, when using the LN as a reference marker, the entry point tends to move medial and slightly caudad. Univariate linear regression analysis suggested that these linear parameters were associated with age (P < 0.01)., Conclusion: In this study, we found that the measurement results of C2 pedicle screw varied based on sex, laterality, and ages for children younger than 18 years. The entry point of the screws facilitating ideal trajectory tends to change in a linear way as a function of age. This information helps the surgeon to establish the specific anatomy related to C2 pedicle screw placement to facilitate fixation in the pediatric patients., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)