Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China.
J Orthop Surg Res. 2023 Mar 29;18(1):257. doi: 10.1186/s13018-023-03746-0.
To explore the value of vertebral bone quality (VBQ) scores in diagnosing osteoporosis in patients with lumbar degeneration.
A retrospective analysis was conducted of 235 patients treated with lumbar fusion surgery at the age of ≥ 50; they were divided into a degenerative group and a control group according to the severity of degenerative changes on three-dimensional computed tomography. The L1-4 vertebral body and L3 cerebrospinal fluid signal intensities in the T1-weighted lumbar magnetic resonance imaging (MRI) image were recorded, and the VBQ score was calculated. Demographics, clinical data, and dual-energy X-ray absorptiometry (DXA) indicators were recorded, and the VBQ value was compared with bone density and T-score using the Pearson correlation coefficient. The VBQ threshold was obtained according to the control group and compared with the efficacy of osteoporosis diagnosis based on DXA.
A total of 235 patients were included in the study, and the age of the degenerative group was older than that of the control group (61.8 vs. 59.4, P = 0.026). The VBQ score of the control group suggested a higher correlation with the bone mineral density (BMD) value and T-score (r = - 0.611 and - 0.62, respectively). The BMD value and T-score in the degenerative group were higher than those in the control group (P < 0.05). Receiver-operating characteristic curve analysis showed that the VBQ score had a good predictive ability for osteoporosis (AUC = 0.818), with a sensitivity of 93% and a specificity of 65.4%. Among the undiagnosed osteoporosis patients with T-score, the VBQ score after adjusting the threshold was higher in the degenerative group (46.9% vs. 30.8%).
Emerging VBQ scores can reduce the interference caused by degenerative changes compared to traditional DXA measures. Screening for osteoporosis in patients undergoing lumbar spine surgery provides new ideas.
探讨椎体骨质量（VBQ）评分在诊断腰椎退变患者骨质疏松症中的价值。
对 235 例年龄≥50 岁行腰椎融合术的患者进行回顾性分析；根据三维 CT 退变程度将其分为退变组和对照组。记录腰椎 MRI 矢状位 T1 加权像 L1-4 椎体及 L3 脑脊液信号强度，计算 VBQ 评分。记录患者一般资料、临床资料及双能 X 线吸收法（DXA）指标，采用 Pearson 相关系数比较 VBQ 值与骨密度、T 评分的相关性。根据对照组获得 VBQ 截断值，并与 DXA 诊断骨质疏松的效能进行比较。
共纳入 235 例患者，退变组年龄大于对照组（61.8 岁比 59.4 岁，P=0.026）。对照组 VBQ 评分与骨密度值及 T 评分相关性更高（r 值分别为-0.611、-0.62）。退变组骨密度值及 T 评分均高于对照组（P<0.05）。受试者工作特征曲线分析显示，VBQ 评分对骨质疏松症具有良好的预测能力（AUC=0.818），敏感度为 93%，特异度为 65.4%。在 T 评分未诊断为骨质疏松症的患者中，调整阈值后退变组的 VBQ 评分更高（46.9%比 30.8%）。
与传统 DXA 指标相比，新兴的 VBQ 评分可以减少退变引起的干扰。为腰椎手术患者筛查骨质疏松症提供了新的思路。
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