Assessment of the morpho-densitometric parameters of the lumbar pedicles in osteoporotic and control women undergoing routine abdominal MDCT examinations

Abstract

In transpedicular surgical operations, the pedicle should be safely penetrated. In this study, we hypothesize that morpho-densitometric data describing the physical status of the pedicle isthmus in osteoporotic versus control postmenopausal women may be generated using high-resolution three-dimensional images obtained from routine abdominal multidetector computed tomography (MDCT) scans. Thus, 32 osteoporotic and 38 postmenopausal control women had a routine abdominal scan using a 16-row CT scanner. Images of the pedicle isthmus of the L2-L4 vertebrae were generated at the plane that was vertical to the pedicle axis. Several indices were calculated based on the measurements of outer and inner dimension of the pedicle isthmus, pedicle isthmus area, and pedicle isthmus endosteal area. The mean Hounsfield unit number within the isthmus endosteal area (HU(IEA)) and the trabecular portion of the vertebral body (HU(VERT)) were measured. All subjects had a dual X-ray absorptiometry scan (DXA) in the lumbar spine. Most of the indices calculated showed statistically significant differences between osteoporotic and control women. HU(IEA) was significantly correlated to T-score (r=0.580, P<0.0001). HU(IEA) showed the best discriminatory ability between the two groups (area under ROC curve, 0.840). Routine abdominal MDCT can be used to assess the morpho-densitometric characteristics of the lumbar pedicle isthmus and differentiate osteoporotic from control postmenopausal women.