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European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025

Hounsfield units vs. vertebral bone quality score: which is a better predictor of screw loosening after single-level lumbar interbody fusion?

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Miyazaki Takahiro, Tanioka Satoru, Yamamoto Atsushi, Maeda Masayuki, Aydin Orhun Utku, Hilbert Adam, Ikezawa Munenari, Nishikawa Hirofumi, Fujimoto Masashi, Ishida Fujimaro, Kamei Yusuke, Yoshida Koichiro, Shoda Motoi, Suzuki Hidenori, Mizuno Masaki, Frey Dietmar

Аннотация

PURPOSE: To clarify the ability of the preoperative CT Hounsfield units (HU) of the vertebrae and MRI-based vertebral bone quality (VBQ) score in predicting screw loosening following lumbar interbody fusion.

METHODS: Patients with lumbar degenerative disease who underwent single-level lumbar interbody fusion at five hospitals were enrolled. The HU were assessed at vertebral body and pedicle. The VBQ score was assessed on the T1-weighted sagittal image and defined as the quotient of the median signal intensity of the vertebrae from L1 to L4 divided by the signal intensity of the cerebrospinal fluid. Screw loosening was evaluated by the postoperative CT scans at 12 months or more. Patients were divided into the screw loosening group and no loosening group, and the HU and the VBQ score were compared between the groups.

RESULTS: A total of 107 patients (mean age, 67.8 ± 10.1 years, 62 men) were included. At the vertebral body, the HU of L1, the average HU from L1 to L4, from L1 to L5, and from L1 to S1, and the HU of the upper instrumented vertebra showed a statistically significant difference between the two groups. The average HU of the vertebral body from L1 to L4 showed the highest AUC of 0.651 and sensitivity of 0.818. No significant difference was found in the HU of the pedicle and VBQ score.

CONCLUSION: The preoperative CT HU of the vertebral bodies could reliably predict screw loosening following lumbar interbody fusion. In contrast, the VBQ score did not predict screw loosening.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты