Huang Weibo, Gong Zhaoyang, Zheng Chaojun, Chen Yu, Ma Xiaosheng, Wang Hongli, Jiang Jianyuan
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Global Spine J. 2024 May;14(4):1238-1247. doi: 10.1177/21925682221138261. Epub 2022 Nov 2.
Diagnostic accuracy study.
Previous studies have reported the clinical application of the Vertebral Bone Quality (VBQ) scores for assessing bone density in operative lumbar spine patients. We aim to explore whether the method could be modified and applicable for patients undergoing cervical spine surgery.
Adult patients receiving cervical spine surgery for degenerative diseases between September 2020 and March 2022 with non-contrast T1-weighted MRI and DEXA were included. Correlation between cervical VBQ scores and DEXA T-scores was analyzed using Pearson's correlation. Student's t test was used to present the discrepancy between the VBQ of patients with normal bone density (T ≥ -1.0) and patients with osteopenia/osteoporosis (T < -1.0). Statistical significance was set at 05.
Eighty-three patients (20 patients with T ≥ -1.0 vs 63 patients with T < -1.0 ) were included. Significant difference was found between the cervical VBQ between groups (2.99 ± .79 vs 3.80 ± .81, < .001). Interclass correlation coefficient for inter-rater reliability was .82 (95% CI: .70-.93) and .91(95% CI: .84-.97) for intra-rater reliability. The area under the ROC curve was .78 (95% CI: .65-.90). The DEXA T-score of the femoral neck, total hip and the lowest DEXA T-score were found to be significantly correlated with the cervical VBQ score according to Pearson correlation analysis ( < 001).
This is the first study to apply the VBQ method to assess the bone density in preoperative cervical spine patients. Cervical VBQ scores were significantly correlated with DEXA T-score. With an overall accuracy of .78, the radiation-free and cost-effective method could be a potential tool for screening patients with osteopenia and osteoporosis before surgery.
诊断准确性研究。
既往研究报道了椎体骨质量（VBQ）评分在评估腰椎手术患者骨密度方面的临床应用。我们旨在探讨该方法是否可修改并适用于接受颈椎手术的患者。
纳入2020年9月至2022年3月期间因退行性疾病接受颈椎手术且行非增强T1加权MRI和双能X线吸收法（DEXA）检查的成年患者。采用Pearson相关性分析颈椎VBQ评分与DEXA T值评分之间的相关性。采用Student t检验比较骨密度正常（T≥-1.0）患者与骨质减少/骨质疏松（T＜-1.0）患者的VBQ差异。设定统计学显著性水平为0.05。
共纳入83例患者（T≥-1.0的患者20例，T＜-1.0的患者63例）。两组间颈椎VBQ存在显著差异（2.99±0.79对3.80±0.81，P＜0.001）。组间信度的组内相关系数为0.82（95%CI：0.70-0.93），组内信度为0.91（95%CI：0.84-0.97）。ROC曲线下面积为0.78（95%CI：0.65-0.90）。根据Pearson相关性分析，发现股骨颈、全髋部DEXA T值评分及最低DEXA T值评分与颈椎VBQ评分显著相关（P＜0.001）。
这是第一项将VBQ方法应用于评估颈椎手术术前患者骨密度的研究。颈椎VBQ评分与DEXA T值评分显著相关。该无辐射且成本效益高的方法总体准确率为0.78，可能是术前筛查骨质减少和骨质疏松患者的潜在工具。
