ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2021
Prediction of osteoporotic fragility re-fracture with lumbar spine DXA-based derived bone strain index: a multicenter validation study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- A bibliometric analysis of acupuncture applied to primary osteoporosis.Frontiers in medicine · 2025Pooled it
- Integration of Multi-Scale Predictive Tools of Bone Fragility: A Structural and Material Property Perspective.Materials (Basel, Switzerland) · 2025Review
- Improving decomposition image quality in dual-energy chest radiography using two-dimensional crisscrossed anti-scatter grid.Medical physics · 2025Article
- Osteoporosis and Normocalcemic Primary Hyperparathyroidism (Conservatively or Surgically Managed).Journal of clinical medicine · 2024Review
- Excess dietary salt is associated with an altered bone strain index, degraded bone microarchitecture, vertebral fractures, and increased prevalence of osteoporosis in postmenopausal women-A study from a teaching hospital in southern India.Aging medicine (Milton (N.S.W)) · 2024Article
- DXA-derived lumbar bone strain index corrected for kyphosis is associated with vertebral fractures and trabecular bone score in acromegaly.Endocrine · 2024Article
- DXA beyond bone mineral density and the REMS technique: new insights for current radiologists practice.La Radiologia medica · 2024Review
- Usefulness of DXA-based bone strain index in postmenopausal women with type 2 diabetes mellitus.Archives of osteoporosis · 2024Article
- The relationship between bone strain index, bone mass, microarchitecture and mechanical behavior in human vertebrae: an ex vivo study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Generation and Validation of Normative, Age-Specific Reference Curves for Bone Strain Index in Women.Diagnostics (Basel, Switzerland) · 2024Article
- Assessment of DXA derived bone quality indexes and bone geometry parameters in early breast cancer patients: A single center cross-sectional study.Bone reports · 2023Article
- Relationship between trabecular bone score, bone mineral density and vertebral fractures in patients with axial spondyloarthritis.BMC musculoskeletal disorders · 2023Article
- The Bone Strain Index: An Innovative Dual X-ray Absorptiometry Bone Strength Index and Its Helpfulness in Clinical Medicine.Journal of clinical medicine · 2022Review
- DXA-Based Bone Strain Index: A New Tool to Evaluate Bone Quality in Primary Hyperparathyroidism.The Journal of clinical endocrinology and metabolism · 2021Article
- Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index.Frontiers in medicine · 2020Review
- Hip Structural Analysis and Bone Strain Index in Clinical Practice: Their Utility Beyond BMD.Indian journal of endocrinology and metabolismReview
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8 authors at 3 institutions in 1 country.
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Abstract
A new qualitative index of bone strength, based on finite element analysis and named bone strain index, has been recently developed from lumbar DXA scan. This study shows that BSI predicts subsequent re-fracture in osteoporotic patients affected by fragility fractures.
introductionDual-energy X-ray absorptiometry (DXA) can provide quantitative (bone mineral density, BMD) and qualitative (trabecular bone score, TBS) indexes of bone status, able to predict fragility fractures in most osteoporotic patients. A new qualitative index of bone strength, based on finite element analysis and named bone strain index (BSI), has been recently developed from lumbar DXA scan. This study presents the validation results of BSI prediction for re-fracture in osteoporotic patients with fragility fractures.
methodsIn three academic hospitals, 234 consecutive fractured patients with primary osteoporosis (209 females) performed a spine X-ray for the calculation of spine deformity index (SDI) and DXA densitometry for BMD, TBS and BSI at the basal time and in the follow-up at each clinical check. A subsequent fracture was considered as one unity increase of SDI.
resultsFor each unit increase of the investigated indexes, the univariate hazard ratio of re-fracture, 95% CI, p value and proportionality test p value are for age 1.040, 1.017-1.064, 0.0007 and 0.2529, respectively, and for BSI 1.372, 1.038-1.813, 0.0261 and 0.5179, respectively. BSI remained in the final multivariate model as a statistically significant independent predictor of a subsequent re-fracture (1.332, 1.013-1.752 and 0.0399) together with age (1.039, 1.016-1.064 and 0.0009); for this multivariate model proportionality test, p value is 0.4604.
conclusionsBSI appears to be a valid DXA index of prediction of re-fracture, and it can be used for a more refined risk assessment of osteoporotic patients.
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