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Study Design
Retrospective radiological analysis.
Objective
To assess bone mineral mass distribution within cervical vertebrae based on Hounsfield unit (HU) measurement, and explore its correlation with intervertebral disc degeneration.
Method
Three hundred and twenty-four patients with degenerative cervical spine disease were retrospectively rev...
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This study aimed to observe the distribution and morphological characteristics of the trabecular bone in the uncinate process of the cervical spine on micro-computed tomography (Micro-CT) to identify the morphological characteristics of the microstructure in the uncinate process. Micro-CT scans were performed on 31 sets of C3-C7 vertebrae comprisin...
Citations
... Many studies have shown that the Hounsfield unit (HU) values of the bone trabecula obtained by a routine CT can be used to assess osteoporosis [5], such as in the lumbar spine [6][7][8], cervical spine [9,10], thoracic spine [11], femur [12], pelvis [13], and ulna [14]. In clinical practice, chest CT [15], a widely used and highly accessible test, can be used for lung cancer screening and chronic obstructive pulmonary disease detection. ...
Study Design: A retrospective study.Purpose: To investigate the correlation between Hounsfield unit (HU) values measured by chest computed tomography (CT) and dual-energy Xray absorptiometry (DXA) T-scores. HU-based thoracolumbar (T11 and T12) cutoff thresholds were calculated for a cohort of Chinese patients.Overview of Literature: For patients with osteoporosis, the incidence of fractures in the thoracolumbar segment is significantly higher than that in other sites. However, most current clinical studies have focused on L1.Methods: This retrospective study analyzed patients who underwent chest CT and DXA at our hospital between August 2021 and August 2022. Thoracic thoracolumbar segment HU values, lumbar T-scores, and hip T-scores were computed for comparison, and thoracic thoracolumbar segment HU thresholds suggestive of potential bone density abnormalities were established using receiver operating characteristic curves.Results: In total, 470 patients (72.4% women; mean age, 65.5±12.3 years) were included in this study. DXA revealed that of the 470 patients, 90 (19%) had osteoporosis, 180 (38%) had reduced osteopenia, and 200 (43%) had normal bone mineral density (BMD). To differentiate osteoporosis from osteopenia, the HU threshold was established as 105.1 (sensitivity, 54.4%; specificity, 72.2%) for T11 and 85.7 (sensitivity, 69.4%; specificity, 61.1%) for T12. To differentiate between osteopenia and normal BMD, the HU threshold was 146.7 for T11 (sensitivity, 57.5%; specificity, 84.4%) and 135.7 for T12 (sensitivity, 59.5%; specificity, 80%).Conclusions: This study supports the significance of HU values from chest CT for BMD assessment. Chest CT provides a new method for clinical opportunistic screening of osteoporosis. When the T11 HU is >146.7 or the T12 HU is >135.7, additional osteoporosis testing is not needed unless a vertebral fracture is detected. If the T11 HU is <105.1 or the T12 HU is <85.7, further DXA testing is strongly advised. In addition, vertebral HU values that fall faster than those of the T11 and L1 vertebrae may explain the high incidence of T12 vertebral fractures.
... In this study, an interesting phenomenon was found that the HU values of L1, L4 and L5 in the 70-79 age group showed abnormal increases compared with those in the 60-69 age group. The same phenomenon was also found in Wanghui's study on the HU value of cervical vertebrae (15). The HU value of cervical vertebrae over 70 years old was higher than that of those between 60 and 70 years old. ...
Study Design
Retrospective radiological analysis.
Objective
The aim of this study is to evaluate the distribution of bone mineral density (BMD) in lumbar vertebrae using the Hounsfield unit (HU) measurement method and investigate the clinical implications of HU values for assessing lumbar vertebrae BMD.
Method
Two hundred and ninety-six patients were retrospectively reviewed and divided into six groups according to age: Group 1(20–29 years old), Group 2 (30–39 years old), Group 3 (40–49 years old), Group 4 (50–59 years old), Group 5 (60–69 years old), Group 6 (70–79 years old). Six different locations from each vertebra of L1-L5 were selected as regions of interest: the anterior, middle and posterior parts of the upper and lower slices of the vertebrae. HU values were measured for the six regions of interest, followed by statistical analysis.
Results
The HU values of vertebrae showed a decreasing trend from young patients to elderly patients in Group 1 to Group 5. There was no significant difference in HU values among different vertebrae in the same age group. In all age groups, the HU values of the anterior and posterior part of the vertebral body were significantly different from L1 to L3, with the anterior part of the vertebral body having lower HU values than the posterior part. The HU values of the anterior and posterior part of the vertebral body of L4 and L5 were statistically significant only in Group 5 and Group 6, and the HU values of the anterior part of the vertebral body were lower than those of the posterior part. The HU values of posterior part of L4 and L5 in Group6 were higher than those in Group5.
Conclusion
Bone mineral density in the lumbar vertebrae is not uniformly distributed, potentially attributed to varying stress stimuli. The assessment of local HU values in the lumbar spine is of significant importance for surgical treatment.
... The correlation between osteoporosis and disc degeneration remains debatable in the scientific community to date. Liang et al. (8) demonstrated through a retrospective study that reduced vertebral bone mineral density (BMD), osteoporosis, and the exacerbation of disc degeneration were correlated. On the other hand, Kaiser et al. (9) demonstrated, through a prospective study, that higher trabecular BMD is negatively associated with disc height loss. ...
Introduction
The relationship between intervertebral disc degeneration (IVDD) and osteoporosis (OP), diagnosed primarily using bone mineral density (BMD), remains unclear so far. The present study, therefore, aimed to investigate the potential relationship between osteoporosis and intervertebral disc degeneration using Mendelian randomization and genome-wide association analyses. Specifically, the impact of bone mineral density on the development of intervertebral disc degeneration was evaluated.
Materials and methods
The genome-wide association studies (GWAS) summary data of OP/BMDs and IVDD were collected from the FinnGen consortium, the GEFOS consortium, and MRC-IEU. The relationship between IVDD and OP was then explored using TSMR. The inverse-variance weighted (IVW) method was adopted as the primary effect estimate, and the reliability and stability of the results were validated using various methods, including MR-Egger, weighted median, simple mode, weighted mode, and MR-PRESSO.
Results
No significant causal relationship was observed between OP and IVDD (IVW, P > 0.05) or between femoral neck BMD (FA-BMD) and IVDD when OP and FA-BMD were used as exposures. However, increased levels of total body BMD (TB-BMD) and lumbar spine BMD (LS-BMD) were revealed as significant risk factors for IVDD (TB-BMD: IVW, OR = 1.201, 95% CI: 1.123–1.284, P = 8.72 × 10⁻⁸; LS-BMD: IVW, OR = 1.179, 95% CI: 1.083–1.284, P = 1.43 × 10⁻⁴). Interestingly, both heel BMD (eBMD) and femur neck BMD (FN-BMD) exhibited potential causal relationships (eBMD: IVW, OR = 1.068, 95% CI: 1.008–1.131, P = 0.0248; FN-BMD, IVW, OR = 1.161, 95% CI: 1.041–1.295, P = 0.0074) with the risk of IVDD. The reverse MR analysis revealed no statistically causal impact of IVDD on OP and the level of BMD (P > 0.05).
Conclusion
OP and the level of FA-BMD were revealed to have no causal relationship with IVDD. The increased levels of TB-BMD and LS-BMD could promote the occurrence of IVDD. Both eBMD and FN-BMD have potential causal relationships with the risk of IVDD. No significant relationship exists between IVDD and the risk of OP. Further research is warranted to comprehensively comprehend the molecular mechanisms underlying the impact of OP and BMD on IVDD and vice versa.
... However, studies of the relationship between osteoporosis and disk degeneration in pre and postmenopausal women have found that patients with lower BMD appear to have a lower incidence of IVDD [15,17,18,31]. Liang et al. [32] measured cervical HU values in 324 patients with degenerative cervical spondylosis and found that the HU values of cervical vertebral segments were inconsistent and unevenly distributed, and that decreased vertebral BMD and vertebral osteoporosis may trigger or exacerbate adjacent disk degeneration. Fujita et al. [33] analyzed the clinical data from musculoskeletal examination of 276 subjects and examined the independent correlation between osteoporosis and IVDD at Content courtesy of Springer Nature, terms of use apply. ...
This study aimed to investigate the causal relationship between bone mineral density (BMD) and intervertebral disk degeneration (IVDD) using a two-sample bidirectional Mendelian randomization analysis. Summary-level data from the Genome-Wide Association Study (GWAS) were used. Instrumental variables (IVs) for IVDD were selected from the large-scale Genome-Wide Association Study (GWAS) (20,001 cases and 164,682 controls). Bone mineral density (BMD) at five different sites (heel (n = 426,824), total body (TB) (n = 56,284), forearm (FA) (n = 8143), femoral neck (FN) (n = 32,735), and lumbar spine (LS) (n = 28,498)) was used as a phenotype for OP. Bidirectional causality between IVDD and BMD was assessed using inverse variance weighting (IVW) and other methods. Related sensitivity analyses were performed. Myopia was also analyzed as a negative control result to ensure the validity of IVs. Heel bone mineral density (heel BMD), total body bone mineral density (TB-BMD), femoral neck bone mineral density (FN-BMD), and lumbar spine bone mineral density (LS-BMD) have a direct causal relationship on intervertebral disk degeneration (IVDD) [heel BMD-related analysis: beta = 0.06, p = 0.03; TB-BMD-related analysis: beta = 0.18, p = 8.72E-08; FN-BMD-related analysis: beta = 0.15, p = 4.89E-03; LS-BMD-related analysis: beta = 0.16, p = 1.43E-04]. There was no evidence of a significant causal effect of IVDD on BMD. In conclusion, our study found a significant positive causal effect of lower BMD on IVDD, and we identified significant causal effects of heel, TB-, FN-, and LS-BMD on IVDD, but there was no evidence of a significant causal effect of IVDD on BMD.
... Some argue that denser vertebral bone accelerates disc degeneration, whereas lower vertebral bone density delays disc degeneration [4][5][6]. Another view is the exact opposite, that is, that a less dense vertebral body accelerates disc degeneration, while a healthy vertebral bone structure protects the disc [7][8][9]. Still others believe that the bone density of the vertebral body does not correlate with disc degeneration [10,11]. ...
... Of the cadaveric studies, 1 concluded that they were negatively correlated and 1 concluded that they were not correlated. The earliest of these studies was published in 1998 [21] and the most recent in 2022 [7]. The largest sample size was the study by Livshits et al. [16] and the smallest sample size was the study by Tosun et al. [6]. ...
... In terms of imaging tools, the most used tool for measuring bone mineral density was dual-energy X-ray absorptiometry (DEXA), while some studies also used quantitative computed tomography (QCT). One study [14] used the dynamic computed tomographic perfusion (CTP) technique to detect indicators related to bone marrow microcirculation perfusion, and two other studies [7,9] used Hounsfield Unit (HU) values from computed has a significant promotion effect on bone mass and bone strength in OVX rats, but no significant effect on disc degeneration Irrelevant tomography (CT) instead of bone density. Magnetic resonance imaging (MRI) is a widely used tool to assess disc degeneration. ...
The effect of vertebral osteoporosis on disc degeneration is still debated. The purpose of this study was to provide a systematic review of studies in this area to further reveal the relationship between the two. Relevant studies were searched in electronic databases, and studies were screened according to inclusion and exclusion criteria, and finally, basic information of the included studies was extracted and summarized. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 34 publications spanning 24 years were included in our study. There were 19 clinical studies, including 12 prospective studies and 7 retrospective studies. Of these, 7 considered vertebral osteoporosis to be positively correlated with disc degeneration, 8 considered them to be negatively correlated, and 4 considered them to be uncorrelated. Two cadaveric studies were included, one considered the two to be negatively correlated and one considered them not to be correlated. Seven animal studies were included, of which five considered a positive correlation between vertebral osteoporosis and disc degeneration and two considered a negative correlation between the two. There were also 6 studies that used anti-osteoporosis drugs for intervention, all of them were animal studies. Five of them concluded that vertebral osteoporosis was positively associated with disc degeneration, and the remaining one concluded that there was no correlation between the two. Our systematic review shows that the majority of studies currently consider an association between vertebral osteoporosis and disc degeneration, but there is still a huge disagreement whether this association is positive or negative. Differences in observation time and follow-up time may be one of the reasons for the disagreement. A large number of clinical and basic studies are still needed in the future to further explore the relationship between the two.
... Another study showed that inter-vertebral disk degeneration is related to osteopenia of adjacent vertebrae [25]. We think it may be due to the influence of the cervical on the mechanical duration of the pathological state and the disease time of long-term cervical loading may affect bone mineral density. ...
Study design
This study was a retrospective review.
Objective
Bone mineral density (BMD) at the surgical site is associated with complications of surgical internal fixation, and it is very important to study the cervical BMD of patients with cervical spondylosis who need surgery and the related factors that affect cervical BMD. It is still unclear about the age-related influence of disease time, cervical alignment and range of motion (ROM) on cervical vertebral Hounsfield unit (HU) value.
Methods
This retrospective study was conducted on patients who underwent cervical surgery at one institution between January 2014 and December 2021. Age, sex, body mass index (BMI), disease type, comorbidities, neck pain, disease time, C2-7 Cobb angle (CA), cervical ROM and the C2-C7 vertebral HU value were recorded. The association between cervical HU value and each parameter of interest was assessed using the Pearson correlation coefficient. Multivariable linear regression analysis was performed to examine the relative influence of the multiple factors on cervical vertebral HU value.
Results
Among patients younger than 50 years old, the HU value of the cervical vertebral in females was higher than that of males, but after the age of 50 years, the value of females was lower than that of males and decreased significantly after 60 years old. In addition, cervical HU value was significantly correlated with the disease time, flexion CA and ROM. Our age-related subgroup of multivariate linear regression analyses shows that disease time and flexion CA negatively affected the C6-7 HU value in more than 60-year-old males and in more than 50-year-old females.
Conclusions
Disease time and flexion CA were negatively affecting the C6-7 HU values in more than 60-year-old males and in more than 50-year-old females. More attention should be paid to bone quality in cervical spondylosis patients with longer disease time and larger convex of flexion CA.
... Gou et al [24] suggest that the duration of symptoms was an independent risk factor for poor post-operative e cacy in patients with degenerative cervical myelopathy. Another study showed that intervertebral disc degeneration is related to osteopenia of adjacent vertebrae [25]. We think it may be due to the in uence of the cervical on the mechanical duration of the pathological state and the disease time of long-term cervical loading may affect bone mineral density. ...
Study Design: This study was a retrospective review.
Objective: Bone mineral density (BMD) at the surgical site is associated with complications of surgical internal fixation, it is very important to study the cervical BMD of patients with cervical spondylosis who need surgery and the related factors that affect cervical BMD. It is still unclear whether the age-related influence of disease time, cervical alignment, and ROM on cervical vertebral Hounsfield unit (HU) value.
Methods： This retrospective study was conducted on patients who underwent cervical surgery at one institution between January 2014 and December 2021. For age, sex, body mass index (BMI), disease type, comorbidities, neck pain, disease time, C2-7 cobb angle (CA), cervical range of motion and the C2-C7 vertebral HU value were recorded. The association between cervical HU value and each parameter of interest was assessed using the Pearson correlation coefficient. Multivariable linear regression analysis was performed to examine the relative influence of the multiple factors on cervical vertebral HU value.
Results： Among patients younger than 50 years old, the HU value of the cervical vertebral in females was higher than that in males, but after the age of 50 years old, the female was lower than that in males and decreased significantly after 60 years old. In addition, cervical HU value was significantly correlated with the disease time, flexion CA and ROM. Our age-related subgroup of multivariate linear regression analyses that disease time and flexion CA negative affected C6-7 HU value in more than 60 years old males and in more than 50 years old females.
Conclusions： Disease time and flexion CA were negative affecting the C6-7 HU values in more than 60 years old males and in more than 50 years old females. more attention should be paid to bone quality in cervical spondylosis patients with longer disease time and larger convex of flexion CA.
... In recent years, the application of CT values to evaluate vertebral bone mineral density has become a research hotspot, especially in lumbar vertebrae, cervical vertebrae, ankylosing spondylitis, and degenerative lumbar scoliosis (30,31). Our study was the first to use the Hounsfield unit for assessing asymmetrical loss of vertebral bone mineral density and its correlation with curve severity in adolescent idiopathic scoliosis. ...
Background:
Low bone mass concomitantly occurs in patients with adolescent idiopathic scoliosis (AIS) and can persist until skeletal maturity. The purpose of this study was to assess the asymmetrical loss of vertebral bone mineral density (vBMD) and its correlation with curve severity in patients with AIS using Hounsfield unit (HU) values measured from computed tomography scans.
Methods:
A total of 93 AIS patients were retrospectively recruited. The HU values of the vertebral body (VB-HU) and pedicle screw trajectory (PST-HU) were measured from four vertebrae above (Apex - 4) to four below (Apex + 4) the apical vertebra (Apex) of the major curve. The VB-HU and PST-HU at the upper end vertebra, Apex, and lower end vertebra within the concave and convex sides of the major and minor curves and stable vertebrae were obtained.
Results:
A significant correlation was found between the Cobb angle and VB-HU at the periapical levels of the major curve. VB-HU and PST-HU at periapical levels were significantly greater within the concavity than the convexity of both major and minor curves. The asymmetric ratios of VB-HU and PST-HU were significantly correlated with the major curve Cobb angle, peaked at the apex, and gradually diminished from the apex to the end vertebrae. The asymmetrical loss of vBMD aggravated with the progression of curve severity, presenting as VB-HU, significantly decreased within the convexity and insignificantly decreased within the concavity of the major curve.
Conclusion:
The asymmetrical loss of vBMD was associated with the progression of curve severity in AIS. For patients with severe AIS, the distraction of the pedicle screws at the concave side should be a priority in correcting the major curve, and supplemental anchors and larger-sized screws should be placed within the convex side around the apex of the major curve to reduce the risk of screw loosening after surgery.
... The height of the anterior column was measured as the average value of the anterior-inferior intersection of the lower vertebral body and the anterior-superior intersection of the upper vertebral body (Figure 3). The HU values (13) were measured using an elliptical region of interest function in the median sagittal position of the cervical spine ( Figure 4). ...
Objectives
This study aims to compare the outcomes between two anterior decompression and fusion techniques to treat multilevel cervical spondylotic myelopathy (MCSM).Methods
After the screening for eligibility, a total of 66 patients were admitted to this study. These participants underwent anterior surgeries due to MCSM in our hospital between June 2016 and July 2018. All participants underwent either the anterior cervical discectomy and fusion (ACDF) surgery (ACDF group) or the combination of ACDF and anterior cervical corpectomy and fusion (ACCF), which was the anterior cervical hybrid decompression and fusion (ACHDF) surgery group. All the patients were followed up ≥18 months, the average latest followed up time was 23.64 (±2.69) months. The length of hospitalization, operation time, blood loss, visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, improvement rate, Hounsfield units (HU) of C3–C7, cobb angle, and anterior column height of fusion levels pre and post operation were analyzed.ResultsThere were no statistical differences between the ACDF and ACHDF groups regarding the length of hospitalization, operation time, blood loss, HU of C3–C7, VAS, JOA score, improvement rate, cobb angle, and anterior column height in fusion levels in pre-operation and 3 months after operation (all P > 0.05). However, compared with the ACHDF group, the ACDF group achieved significantly better improvement in the anterior column height of fusion levels in the final 18–29 months post-operatively (P < 0.05).Conclusions
Both approaches of ACDF alone and a combination of ACDF and ACCF can achieve satisfactory outcomes in the treatment of MCSM, but ACDF has better outcomes in maintaining anterior column height of fusion levels.
... Аналогичная тенденция характерна и для трабекулярной кости. По мнению X. Liang et al., необходимо определять не только общую и локальную плотность позвонков, но и изучать ее на трех уровнях в сагиттальной плоскости (верхняя треть, центральная часть, нижняя треть) для выяснения влияния дегенерации дисков на плотность позвонка [28]. Выявлены достоверные отличия плотности компактной кости по задней поверхности позвонков CIII-CV на аксиальных срезах. ...
Introduction The number of surgical interventions on the cervical spine for stenosis has been constantly increasing. This fact proves that there is a need for careful preoperative preparation that would consider the complexity of the intervention and the age of the patients.
Purpose To substantiate the need to include the MSCT data processing algorithm of bone tissue density of vertebral bodies and arches to assess their quality for planning osteoplastic decompressive laminoplasty in patients with cervical spine stenosis due to degenerative changes.
Material and methods This single-center retrospective study investigated qualitative and quantitative characteristics of the spine with radiography and multislice computed tomography (MSCT) in 82 patients with degenerative diseases of the cervical spine and associated spinal canal stenosis (CSS).
Results and discussion The data obtained indicate a tendency for the total density of the cervical vertebrae to increase from C3 to C5 and to decrease caudally, with minimal density in C7 without signs of osteoporosis. A similar trend is characteristic of trabecular bone. The density of the osteon layer of the vertebral arch cortex differs significantly from the density of the outer and inner plates. The total density of the compact layer of the vertebral arch cortex exceeds 785.15 ± 38.4 HU.
Conclusion The data obtained justify the need to include the study of the density of vertebral bodies, vertebral arches, and its thickness in the MSCT data processing algorithm to develop a plan for surgical intervention in patients with cervical spine stenosis in order to obtain objective data on the quality of the bone.
