What is the role of CT-Based Hounsfield Unit assessment in the evaluation of Bone Mineral Density in patients undergoing 1- or 2-level lumbar spinal fusion for degenerative spinal pathologies? - A prospective study
Abstract
BACKGROUND CONTEXT
Computed tomography-based vertebral attenuation values (CT-based HU) have been shown to correlate with T-scores on DEXA scan; and have been acknowledged as an independent factor for predicting fragility fractures. Most patients undergoing lumbar surgeries require CT as part of their pre-operative evaluation.
PURPOSE
The current study was thus planned to evaluate the role of lumbar CT as an opportunistic investigation in determining BMD pre-operatively in patients undergoing lumbar fusion.
STUDY DESIGN
Prospective cohort study PATIENT SAMPLE: : Patients older than 45 years, who underwent one- to two-level lumbar (L3-S1 levels) fusions OUTCOME MEASURES: : Comparison of the quantitative assessment of osteoporosis using Hounsfield Units on CT (L1-L5) and mean lumbar T-scores on DEXA (Dual Energy Xray Absorptiometry) HYPOTHESIS: : HU on CT is comparable to T-score on DEXA as a suitable modality for the assessment of osteoporosis in patients undergoing 1-2 level lumbar fusion METHODS: : A prospective cohort study was conducted between January and December 2021. Patients older than 45 years, who underwent one- to two-level lumbar (L3-S1 levels) fusions and had complete clinico-radiological records, were prospectively enrolled. A comparison was drawn between the HU [measured by placing an oval region of interest (ROI) over axial, sagittal and coronal images of lumbar vertebrae] on CT and T-scores on DEXA, and analyzed statistically. The HU values correlating best…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 87 participants or records.
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