Abstract
BackgroundOsteoporosis is characterized by a deterioration of bone structure and quantity that leads to an increased risk of fractures. The primary diagnostic tool for the assessment of the bone quality is currently the dual-energy X-ray absorptiometry (DXA), which however only measures bone quantity. High-resolution multidetector computed tomography (HR-MDCT) offers an alternative approach to assess bone structure, but still lacks evidence for its validity in vivo. The objective of this study was to assess the validity of HR-MDCT for the evaluation of bone architecture in the lumbar spine.MethodsWe conducted a prospective cross-sectional study to compare the results of preoperative lumbar HR-MDCT scans with those from microcomputed tomography (μCT) analysis of transpedicular vertebral body biopsies. For this purpose, we included patients undergoing spinal surgery in our orthopedic department. Each patient underwent preoperative HR-MDCT scanning (L1-L4). Intraoperatively, transpedicular biopsies were obtained from intact vertebrae. Micro-CT analysis of these biopsies was used as a reference method to assess the actual bone architecture. HR-MDCT results were statistically analyzed regarding the correlation with results from μCT.ResultsThirty-four patients with a mean age of 69.09 years (± 10.07) were included in the study. There was no significant correlation for any of the parameters (bone volume/total volume, trabecular separation, trabecular thickness) between μCT and HR-MDCT (bone volume/total volume: r = − 0.026 and p = 0.872; trabecular thickness: r = 0.074 and r = 6.42; and trabecular separation: r = − 0.18 and p = 0.254).ConclusionTo our knowledge, this is the first study comparing in vivo HR-MDCT with μCT analysis of vertebral biopsies in human patients. Our findings suggest that lumbar HR-MDCT is not valid for the in vivo evaluation of bone architecture in the lumbar spine. New diagnostic tools for the evaluation of osteoporosis and preoperative orthopedic planning are urgently needed.
Highlights
Osteoporosis is a chronic metabolic bone disease that leads to an increased risk of fractures due to a deterioration of bone structure and quantity [1]
The relevance of osteoporosis is not limited to the increased risk of fractures
Reliable knowledge about local bone quality is of high importance in the surgical field as it is indispensable for the planning of any orthopedic surgery
Summary
Osteoporosis is a chronic metabolic bone disease that leads to an increased risk of fractures due to a deterioration of bone structure and quantity [1]. If an increased risk of fractures has to be suspected, dual-energy X-ray absorptiometry (DXA) measurement is the current radiological standard to confirm the diagnosis [6, 7]. DXA remains the most important tool for monitoring purposes, e.g., to evaluate the response to antiresorptive medications during follow-ups, and for preoperative bone assessment [7,8,9]. Osteoporosis is characterized by a deterioration of bone structure and quantity that leads to an increased risk of fractures. The primary diagnostic tool for the assessment of the bone quality is currently the dualenergy X-ray absorptiometry (DXA), which only measures bone quantity. The objective of this study was to assess the validity of HR-MDCT for the evaluation of bone architecture in the lumbar spine
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
