ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024
Forearm bone mineral density predicts screw loosening after lumbar fusion similar to lumbar Hounsfield unit value in patients with lumbar spondylolisthesis.
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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 12 citations in OpenAlex.
- Multimodal model predicts screw loosening at user-specified postoperative time points after single-level lumbar interbody fusion.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
- Forearm bone mineral density predicts subsidence of titanium mesh cage after anterior cervical corpectomy and fusion in patients with cervical spondylosis.Journal of orthopaedic surgery and research · 2025Article
- Modeling and construction of nomogram of cage subsidence after single-segment transforaminal lumbar interbody fusions.Journal of orthopaedic surgery and research · 2025Article
- Predictive Value of Preoperative Nutritional Risk Index for Screw Loosening After Lumbar Interbody Fusion in Elderly Patients With Lumbar Spine Diseases.Orthopaedic surgery · 2025Article
- New Challenges: Use and Interpretation of Radius Bone Mineral Density.The Journal of clinical endocrinology and metabolism · 2024Review
- Forearm bone mineral density as a predictor of adjacent vertebral refracture after percutaneous kyphoplasty in patients with osteoporotic vertebral compression fracture: a retrospective analysis.Journal of orthopaedic surgery and research · 2024Article
- Low bone mineral density: a primer for the spine surgeon.Spine deformity · 2024Review
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9 authors at 3 institutions in 1 country.
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Abstract
Preoperative bone density assessment is necessary to predict screw loosening. The forearm BMD is a useful predictor of BMD-related complications after lumbar operation. Our results show that the forearm BMD is as effective a predictor of screw loosening as the lumbar average HU value. Measurement of the forearm BMD may be a useful adjunct in predicting screw loosening following lumbar fusion. PURPOSE: To determine the relationship between forearm bone mineral density (BMD) and the risk of pedicle screw loosening in patients with lumbar spondylolisthesis.
methodsWe retrospectively evaluated 270 patients who underwent posterior lumbar interbody fusion for lumbar spondylolisthesis. The patients were divided into two groups on the basis of the with or without loose screws: the loosening group and the non-loosening group. The patient's gender, age, BMI, smoking and diabetes histories, and the operative segment were recorded as the basic information. The Hounsfield unit (HU) value for the BMD of the L1-4 lumbar was measured using computed tomography. The patient's distal one-third of the length of the radius and ulna of the non-dominant forearm was chosen as the site for dual-energy X-ray (DXA) bone density testing.
resultsThe rate of screw loosening was 13% at a minimum 12 months follow-up. Average forearm BMD (0.461 ± 0.1 vs 0.577 ± 0.1, p < 0.001) and mean HU value (L1-4) (121.1 ± 27.3 vs 155.6 ± 32.2, p < 0.001) were lower in the screw loosening group than those in the non-loosening group. In multivariate logistic regression analysis, the forearm BMD (OR 0.840; 95%CI 0.797-0.886) and HU value (L1-4) (OR 0.952; 95%CI 0.935-0.969) were independent risk factor for screw loosening. The area under the curve (AUC) for the forearm BMD and HU value for prediction of pedicle screw loosening was 0.802 and 0.811. The forearm BMD cut-off for predicting pedicle screw loosening was 0.543 (sensitivity, 0.800; specificity, 0.864).
conclusionsThe forearm BMD was an independent risk factor for loosening of the lumbar pedicle screws. The forearm BMD was a valid predictor of pedicle screw loosening in patients undergoing lumbar fusion, as was the CT HU value.
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