Predictive factors for osteoporosis in adult spinal deformity patients.

IF 1.8 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-04-09 DOI:10.1007/s43390-025-01088-x

Hiroki Konuma, Junya Katayanagi, Takahiro Iida, Shingo Morishita, Tomoyuki Tanaka, Tsukasa Yanase, Tetsuya Jinno, Hiroyuki Inose

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引用次数: 0

Abstract

Purpose: This study aimed to identify predictive factors for femoral bone mineral density (BMD) in adult patients with spinal deformity and to establish cutoff values for detecting osteoporosis using preoperative computed tomography (CT) scans.

Methods: A retrospective analysis was conducted on 90 patients with adult spinal deformity (ASD) who underwent preoperative bone density testing. Key parameters such as age, body mass index (BMI), and Hounsfield unit (HU) values from various vertebral levels were analyzed. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD T-score, and HU values were measured at C2, C7, T8, T9, L1, L2, and L3.

Results: Multivariate regression analyses identified BMI and HU at C2 as independent predictors of femoral T-score. The following predictive equation was developed: femoral T-score = - 5.178 + 0.053 × BMI + 0.006 × C2 HU (R² = 0.50). The formula derived from these variables explained 50% of the variance in femoral T-score. Receiver operating characteristic analysis identified cutoff values for predicting osteoporosis as 281 for C2 HU and 22.9 for BMI. The areas under the curve were 0.751 and 0.638, respectively.

Conclusion: These findings suggest that HU values from preoperative CT scans can serve as reliable indicators of femoral T-score, offering an alternative to DXA in cases where DXA is unavailable or inaccurate due to factors like severe spinal degeneration. This approach could enhance the preoperative assessment of osteoporosis in ASD patients by facilitating more targeted use of DXA and improving overall clinical decision-making.

Level of evidence: IV.

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成人脊柱畸形患者骨质疏松的预测因素。

目的：本研究旨在确定成年脊柱畸形患者股骨骨密度（BMD）的预测因素，并建立术前计算机断层扫描（CT）检测骨质疏松症的临界值。方法：对90例行术前骨密度检查的成人脊柱畸形（ASD）患者进行回顾性分析。主要参数如年龄、身体质量指数（BMI）和不同椎体水平的Hounsfield单位（HU）值进行分析。采用双能x线吸收仪（DXA）测量BMD t评分，测量C2、C7、T8、T9、L1、L2、L3的HU值。结果：多因素回归分析确定BMI和HU在C2是独立的预测股t评分。建立预测方程：股骨t评分= - 5.178 + 0.053 × BMI + 0.006 × C2 HU （R2 = 0.50）。由这些变量导出的公式解释了股骨t评分50%的方差。受试者工作特征分析确定预测骨质疏松症的临界值为C2 HU为281，BMI为22.9。曲线下面积分别为0.751和0.638。结论：这些发现表明术前CT扫描的HU值可以作为股骨t评分的可靠指标，在由于严重脊柱退变等因素无法获得DXA或DXA不准确的情况下，可以替代DXA。该方法可以通过更有针对性地使用DXA和改善整体临床决策来增强ASD患者骨质疏松症的术前评估。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.