LETTER TO THE EDITOR.

This document is a letter to the editor discussing a study on the predictive factors for pedicle screw loosening following surgery for degenerative lumbar disease. The study compared the accuracy of vertebral bone quality (VBQ) scores and Hounsfield units (HU) values in predicting screw loosening. The results showed that VBQ scores exhibited higher accuracy, but caution is needed in interpreting this conclusion as further validation is required. The letter also highlights the limitations of the study, such as the small sample size and the need for larger, multicenter studies to validate the findings. Overall, the clinical application of this method requires further research and consideration of gender factors and study design limitations. [Extracted from the article]