ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
Assessment of bone quality at the lumbar and sacral spine using CT scans: a retrospective feasibility study in 50 comparing CT and DXA data.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 53 citations in OpenAlex.
- Article
- Diagnostic value of an S1-normalized CT hounsfield unit ratio for identifying acute fractures in complex thoracolumbar osteoporotic deformities.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Preoperative 3D-Planned S1 Corridors Transferred into 2D Fluoroscopy Allow for Safe Intraoperative Large-Diameter Implant Placement: Description of a Novel Sacroiliac Fixation Technique and Proof of Concept in 137 Implantations.Medicina (Kaunas, Lithuania) · 2026Article
- Prediction of Osteoporosis at the Sacrum Using Opportunistic CT of the Abdomen and Pelvis: A Retrospective Feasibility Study in 277 Patients Comparing CT and QCT Data.Journal of clinical medicine · 2026Article
- Diagnostic performance of lumbar computed tomography Hounsfield unit thresholds for osteoporosis and osteopenia: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- The association between bone density evaluated on CT or MRI versus the gold standard dual-energy X-ray absorptiometry (DEXA) in the lumbar spine and hip: a meta-analysis.Brain & spine · 2026Review
- Article
- Novel CT-based vertebral three-dimensional Hounsfield unit for assessment of bone mineral density.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Insertional torque and pullout strength of reinserted screws for sacroiliac joint fusion: Effects of implant dimensions, bone density, and tapping.North American Spine Society journal · 2025Article
- Relationship Between Lumbar Spine Hounsfield Unit Values and Bone Mineral Density in Patients With Osteoarthritis Undergoing Total Hip Arthroplasty.Arthroplasty today · 2025Article
- CT-based vertebral three-dimensional Hounsfield unit can predict the new vertebral fracture after percutaneous vertebral augmentation in postmenopausal women: a retrospective study.Journal of orthopaedic surgery and research · 2025Article
- Patellar Dislocation Patients Had Lower Bone Mineral Density and Hounsfield Unit Values in the Knee Joint Compared to Patients with Anterior Cruciate Ligament Ruptures: A Focus on Cortical Bone in the Tibia.Bioengineering (Basel, Switzerland) · 2025Article
- Comparing adjacent segment biomechanics between anterior and posterior cervical fusion using patient-specific finite element modeling.Asian spine journal · 2024Article
- Biomechanical comparison of reverse offset-L osteotomy and chevron osteotomy in cadaveric hallux valgus surgery.Journal of foot and ankle research · 2024Article
- Surgery for spinal deformity with osteoporosis: Achieving successful fusion.Osteoporosis and sarcopenia · 2024Review
- The correlation between self-Hounsfield units and adjacent vertebral fracture after percutaneous vertebral augmentation: a retrospective cohort study.Quantitative imaging in medicine and surgery · 2024Article
- Article
- Efficacy of two opportunistic methods for screening osteoporosis in lumbar spine surgery patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- Article
- The Use of Intraoperative CT Hounsfield Unit Values for the Assessment of Bone Quality in Patients Undergoing Lumbar Interbody Fusion.Global spine journal · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeComputed tomography (CT) is a standard diagnostic tool for preoperative screening for many indications in spinal and pelvic surgery. The gold standard for diagnosing osteoporosis is standard dual-energy X-ray absorptiometry (DXA). The aim of the present study was to compare the accuracy of Hounsfield unit (HU) measurements not only at the lower lumbar, but also at the sacral spine using standard CT scans. PATIENTS AND
methodsMain inclusion criterion for this retrospective analysis in 50 patients was the availability of both a CT scan of the lumbar and sacral spines and a DXA scan. HUs were measured in intact vertebral bodies L4, L5 and S1. Results of the HU in CT scan were compared to the T-score and bone mineral density in DXA. A group with normal bone density (T-score higher - 1, n = 26) was compared with a group with impaired bone density (T-score lower - 1, n = 24).
resultsA multivariant binary logistic regression analysis showed significant results for HU measurement in L4 (p = 0.009), L5 (p = 0.005) and S1 (p = 0.046) with respect to differentiation between normal and impaired bone quality. Cutoffs between normal and impaired bone density values for trabecular region of interest attenuation for L4, L5 and S1 are presented. In L4 100% sensitivity to detect normal bone was reached when HU was higher than 161, HU higher than 157 in L5 and HU higher than 207 in S1.
conclusionsHU measurements in CT scans have proven to be a feasible tool to additionally assess bone quality at the lumbar and sacral spine with good sensitivity, when compared with the gold standard DXA. LEVEL OF EVIDENCE: III. These slides can be retrieved under Electronic Supplementary Material.
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