98. Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion

• Published in: The spine journal 2021-09, Vol.21 (9), p.S48-S48
• Main Authors: Salzmann, Stephan, Okano, Ichiro, Jones, Conor M., Zhu, Jiaqi, Lu, Shuting, Onyekwere, Ikenna, Balaji, Venkatesh, Reisener, Marie-Jacqueline, Chiapparelli, Erika A., Shue, Jennifer, Carrino, John A., Girardi, Federico P., Cammisa, Frank P., Sama, Andrew A., Hughes, Alexander P.
• Format: Article
• Language: English
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2021.05.123

The importance of bone quality assessment in spine surgery is well recognized. The current gold standard for assessing bone mineral density is dual-energy X-ray absorptiometry (DEXA), however the majority of patients undergoing spinal fusion do not have preoperatively available DEXA data. Furthermore, DEXA has been shown to overestimate BMD in patients with spinal degenerative disease and obesity. Consequently, alternative radiographic measurements using data routinely gathered during preoperative evaluation of spine patients have been explored for the evaluation of bone quality and fracture risk. Opportunistic quantitative computed tomography and more recently the MRI-based vertebral bone quality (VBQ) score both have been shown to correlate with DEXA T-scores and predict osteoporotic fractures. However, to date the correlation between those two modalities has not been studied. The objective of this study was to assess whether the recently described novel VBQ score can predict the prevalence of QCT based osteopenia/osteoporosis and to evaluate the correlation between VBQ and spine QCT BMD measurements. Retrospective study of lumbar spinal fusion patients from a single, academic institution. Patients undergoing lumbar spinal fusion from 2014-2019 with available preoperative CT and T1-weighted MRIs of the lumbar spine. VBQ correlation to BMD. For BMD assessment, asynchronous quantitative computed tomography (QCT) measurements of L1-L2 were performed. An elliptical region of interest was placed anteriorly in the trabecular bone at mid-vertebral height and displaced from the vertebral cortex. The average BMD of L1-L2 was calculated and patients were categorized as either normal BMD (>120 mg/cm3) or osteopenic/osteoporotic (