ArticleNorth American Spine Society journal2026
Quantitative assessment of bone mineral density in cervical spine surgery: Diagnostic accuracy of C2 and C3 Hounsfield units versus cervical vertebral bone quality scores.
Article in North American Spine Society journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Preoperative bone mineral density (BMD) assessment is essential for cervical spine surgery, yet dual-energy X-ray absorptiometry (DXA) is not routinely performed. Opportunistic imaging metrics such as computed tomography-derived Hounsfield units (HU) and magnetic resonance imaging-based vertebral bone quality (VBQ) scores have been proposed as surrogates, but their comparative diagnostic value in the cervical spine remains unclear. Methods: In this retrospective single-center study, 154 patients aged ≥50 years undergoing cervical spine surgery for degenerative diseases were included. All patients underwent cervical CT, cervical MRI, DXA, and bone turnover marker testing within 3 months preoperatively. HU values at C2-C7 were measured on sagittal CT images, and VBQ scores were calculated from T1-weighted MRI. Correlations between imaging parameters and DXA T-scores (lumbar spine, femoral neck, and total hip) were analyzed. Receiver operating characteristic analysis evaluated diagnostic performance for reduced BMD (T-score <-1.0), including sex-specific subgroups. Results: Mean cervical HU values decreased progressively from C4 to C7 and were significantly lower in patients with reduced BMD (all p < .001). C2 HU showed the strongest correlations with DXA T-scores (r = 0.528-0.671). C2 and C3 HU demonstrated numerically higher discriminative ability for identifying reduced BMD (area under the curve [AUC] = 0.737 and 0.741) compared with VBQ (AUC = 0.638) and Goutallier grade (AUC = 0.623). Performance of C2 HU was consistent across sexes. HU values showed weak correlations with β-cross-linked telopeptide of type I collagen and osteocalcin and no association with 25-hydroxyvitamin D or procollagen type I N-terminal propeptide. Conclusions: Upper cervical HU measurements, particularly at C2 and C3, demonstrated favorable discriminative performance for identifying reduced BMD and may serve as a practical opportunistic screening tool in patients undergoing cervical spine surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.