Vertebral bone quality score as a novel predictor of proximal junctional kyphosis after thoracic adolescent idiopathic scoliosis surgery

• Published in: European spine journal 2023-11, Vol.32 (11), p.3996-4002
• Main Authors: Wang, Juehan, Chen, Qian, Ai, Youwei, Huang, Yong, Zhu, Ce, Ding, Hong, Feng, Ganjun, Liu, Limin, Song, Yueming
• Format: Article
• Language: English
• Subjects: Kyphosis; Magnetic resonance imaging; Medicine; Medicine & Public Health; Multivariate analysis; Neurosurgery; Original Article; Osteopenia; Risk factors; Scoliosis; Surgery; Surgical Orthopedics; Thorax; Vertebrae
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-023-07894-z

Introduction Proximal junctional kyphosis (PJK) is one of the most common complications after thoracic AIS surgery. Previous studies reported that the etiology of PJK was associated with osteopenia and meanwhile the AIS patients were found osteopenia which could persist into adulthood. Recently, an MRI-based vertebral bone quality score (VBQ) was reported to be a promising tool which can assess preoperative bone quality. Objective This study aims to evaluate the utility of VBQ score in predicting PJK after corrective surgery for thoracic AIS (Lenke 1 and 2). Methods We conducted a retrospective study to identify the predictive efficiency of VBQ score for PJK in thoracic AIS patients. Demographic, radiographic parameters, and surgical variables were collected. VBQ score was calculated using preoperative T1-weighted MRI. Univariate analysis, linear regression, and multivariate logistic regression were performed to determine potential risk factors of PJK and correlation between other parameters and VBQ score. Receiver operating characteristic analysis and area under the curve values were utilized to evaluate the predictive efficiency of VBQ score for PJK. Results A total of 206 patients (aged 14.4 ± 2.3 years) were included, of which 33 (16.0%) developed PJK. VBQ scores were significantly different between the PJK and non-PJK groups (2.8 ± 0.2 vs 2.5 ± 0.2, P