1. Using advanced imaging to measure bone density, compression fracture risk, and risk for construct failure after spine surgery.
- Author
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Agaronnik ND, Giberson-Chen C, and Bono CM
- Subjects
- Humans, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Osteoporosis diagnostic imaging, Magnetic Resonance Imaging, Spine surgery, Spine diagnostic imaging, Tomography, X-Ray Computed, Fractures, Compression surgery, Fractures, Compression diagnostic imaging, Spinal Fractures surgery, Spinal Fractures diagnostic imaging, Bone Density
- Abstract
Low bone mineral density (BMD) can predispose to vertebral body compression fractures and postoperative instrumentation failure. DEXA is considered the gold standard for measurement of BMD, however it is not obtained for all spine surgery patients preoperatively. There is a growing body of evidence suggesting that more routinely acquired spine imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) can be opportunistically used to measure BMD. Here we review available studies that assess the validity of opportunistic screening with CT-derived Hounsfield Units (HU) and MRI-derived vertebral vone quality (VBQ) to measure BMD of the spine as well the utility of these measures in predicting postoperative outcomes. Additionally, we provide screening thresholds based on HU and VBQ for prediction of osteopenia/ osteoporosis and postoperative outcomes such as cage subsidence, screw loosening, proximal junctional kyphosis, and implant failure., Competing Interests: Declaration of competing interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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