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Systematic evaluation of vertebral bone quality score as an opportunistic screening method for BMD in spine surgery patients

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Abstract

Purpose

This study aimed to evaluate and compare the predictive value of vertebral bone quality (VBQ) score for low BMD and osteoporosis. Furthermore, we sought to enhance diagnostic effectiveness by integrating VBQ with easily accessible patient-specific factors.

Methods

We retrospectively analyzed data from 180 patients. VBQ was obtained by preoperative MRI. Low BMD was classified as meeting the standards for either osteopenia or osteoporosis. The receiver operating characteristic curve analysis and multivariate logistic regression were used to detect the ability of variables to assess BMD. The z-test was used to compare the area under the curves of different variables.

Results

VBQ was more effective in identifying low BMD than osteoporosis (AUC, 0.768 vs. 0.613, p = 0.02). Elevated VBQ (OR 6.912, 95% CI 2.72–17.6) and low BMI (0.858, 0.76–0.97) were risk factors for low BMD, while the risk factor for osteoporosis was age (1.067, 1.02–1.12), not VBQ. ROC analysis showed that AUCs were 0.613 for VBQ and 0.665 for age when screening for osteoporosis. The combined variable of VBQ, sex, age, and BMI obtained by logistic regression significantly improved the efficacy of BMD screening, with an AUC of 0.824 for low BMD and 0.733 for osteoporosis.

Conclusion

VBQ is better at detecting low BMD than identifying osteoporosis. The ability of VBQ to predict osteoporosis is limited, and a similar diagnostic efficacy can be achieved with age. Incorporating VBQ alongside demographic data enhances the efficiency of BMD assessment. With the development of artificial intelligence in medicine, this simple method is promising.

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Data availability

Data are available from the corresponding author on reasonable request.

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Author information

Author notes

  1. Yunsheng Wang and Ning Song have contributed equally.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Qiaoxi District, 139 Ziqiang Road, Shijiazhuang, 050051, China

    Yunsheng Wang, Jia Li, Ruoyu Li & Linfeng Wang

  2. Key Laboratory of Orthopedic Biomechanics of Hebei Province, Shijiazhuang, Hebei, China

    Yunsheng Wang, Ning Song, Jia Li, Ruoyu Li & Linfeng Wang

  3. Department of Operating Room, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China

    Ning Song

  4. Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei, China

    Jiali Zhang

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  1. Yunsheng Wang
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  2. Ning Song
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  3. Jiali Zhang
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  4. Jia Li
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  5. Ruoyu Li
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  6. Linfeng Wang
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Contributions

Conception and design: all authors. Acquisition of data: Y Wang, N Song, J Zhang. Statistical analysis: J Li, R Li. Drafting the article: Y Wang, N Song. Critically revising the article: all authors. Reviewed and approved the final version of the manuscript: all authors. Study supervision: L Wang.

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Correspondence to Linfeng Wang.

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Wang, Y., Song, N., Zhang, J. et al. Systematic evaluation of vertebral bone quality score as an opportunistic screening method for BMD in spine surgery patients. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08284-9

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