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Bone density measured on sagittal reconstructed CT is highly correlated with axial CT but both measurements are only moderately correlated with DEXA T-scores

Authors :
Shivam N. Upadhyaya
Charles H. Crawford, III
Grant O. Schmidt
Derek Arrington
John R. Dimar, II
Steven D. Glassman
Jeffrey L. Gum
Amer H. Ahmad
Leah Y. Carreon
Source :
Interdisciplinary Neurosurgery, Vol 37, Iss , Pp 101980- (2024)
Publication Year :
2024
Publisher :
Elsevier, 2024.

Abstract

Background: During the preoperative evaluation of a patient being considered for spinal surgery, Dual-energy x-ray absorptiometry (DEXA) has been traditionally used to diagnose poor bone mineral density (BMD) as a risk factor. As ordering a DEXA can add cost and delay diagnosis, spine surgeons have more recently began to use Hounsfield Units (HU) measured on computed tomography scans (CT) as a measure of BMD. The aim of our study was to evaluate associations between DEXA and HU on lumbar spine CT scans. Methods: Forty-two patients (32 female, 10 male, mean age = 67.7 years) with DEXA and lumbar spine CT scans performed within one year of each other were identified. DEXA T-scores were collected from the hip, forearm and L1-L4. HU was determined using the maximum region of interest within the cancellous area in the mid-vertebral body from L1-L4 in the sagittal and axial planes. Results: Using the lowest T-score, 8 (19 %) cases were osteoporotic and 25 (60 %) were osteopenic. Statistically significant differences in HU were seen in osteoporotic cases (Axial HU = 59.2, Sagittal HU = 61.1, p = 0.006) compared to osteopenic (Axial HU = 119.8, Sagittal HU = 122.9) and normal cases (Axial HU = 141.2, Sagittal HU = 142.3). There were moderate associations between the spine T-scores and CT HUs (Axial HU:r2 = 0.50, Sagittal HU:r2 = 0.49, p

Details

Language :
English
ISSN :
22147519
Volume :
37
Issue :
101980-
Database :
Directory of Open Access Journals
Journal :
Interdisciplinary Neurosurgery
Publication Type :
Academic Journal
Accession number :
edsdoj.35229e278bb2494a829248ca2901b256
Document Type :
article
Full Text :
https://doi.org/10.1016/j.inat.2024.101980