Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China.
Department of Spine Surgery, Weifang People's Hospital, Weifang, Shandong, China.
Osteoporos Int. 2024 Nov;35(11):1881-1895. doi: 10.1007/s00198-024-07190-6. Epub 2024 Aug 1.
The importance of osteoporosis assessment before lumbar surgery is well recognized. The MRI-based Vertebral Bone Quality (VBQ) score is introduced to evaluate bone quality; however, its diagnostic value has not been well documented. The purpose of this meta-analysis was to summarize the diagnostic value of the VBQ score for osteoporosis or osteopenia in patients undergoing lumbar surgery. We comprehensively searched electronic databases for studies exploring the diagnostic accuracy of the VBQ score for osteoporosis/osteopenia in patients with lumbar disease following the PRISMA guidelines. The quality of the included studies was assessed. The VBQ scores were compared between the groups, and the pooled sensitivity, specificity, and summary receiver operating characteristic (ROC) were calculated. Publication bias was assessed, and meta-regression was conducted. We included 17 studies with a total of 2815 patients, with a mean age of 66.4 years and a percentage of females of 72.5%. According to the QUADAS-2 tool, the quality of the included studies was relatively high. The results showed a significantly higher VBQ score in the osteoporosis/osteopenia group compared with the control group. According to the mean VBQ cutoff value of 3.02 ± 0.38 for the diagnosis of osteoporosis, the pooled sensitivity and specificity were 0.76 and 0.74, respectively, and the AUC was 0.81. According to the mean VBQ cutoff value of 2.31 ± 0.18 for the diagnosis of osteopenia, the pooled sensitivity and specificity were 0.78 and 0.58, respectively, and the AUC was 0.76. The MRI-based VBQ score could provide useful information for identifying patients with low bone mass who need further evaluation. Future prospective studies are still needed to evaluate the complementary role of the VBQ score.
在腰椎手术前评估骨质疏松症的重要性已得到广泛认可。基于 MRI 的椎体骨质量 (VBQ) 评分用于评估骨质量，但尚未充分记录其诊断价值。本荟萃分析的目的是总结 VBQ 评分在评估接受腰椎手术的患者骨质疏松症或骨量减少的诊断价值。我们根据 PRISMA 指南全面搜索电子数据库，以探索腰椎疾病患者的 VBQ 评分对骨质疏松症/骨量减少的诊断准确性的研究。评估了纳入研究的质量。比较了两组的 VBQ 评分，并计算了汇总的敏感性、特异性和汇总受试者工作特征 (ROC)。评估了发表偏倚，并进行了荟萃回归。我们纳入了 17 项研究，共 2815 名患者，平均年龄为 66.4 岁，女性比例为 72.5%。根据 QUADAS-2 工具，纳入研究的质量相对较高。结果显示，骨质疏松症/骨量减少组的 VBQ 评分明显高于对照组。根据骨质疏松症诊断的平均 VBQ 截断值 3.02±0.38，汇总敏感性和特异性分别为 0.76 和 0.74，AUC 为 0.81。根据诊断骨量减少的平均 VBQ 截断值 2.31±0.18，汇总敏感性和特异性分别为 0.78 和 0.58，AUC 为 0.76。基于 MRI 的 VBQ 评分可为识别需要进一步评估的低骨量患者提供有用信息。仍需要未来的前瞻性研究来评估 VBQ 评分的补充作用。
