ArticleBMC musculoskeletal disorders2026
Region-specific QCT thresholds for osteoporosis assessment in the thoracic spine: why lumbar cut-offs fail.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundQuantitative computed tomography (QCT) is increasingly used for preoperative bone quality assessment in spine surgery. However, established QCT osteoporosis thresholds are based on lumbar reference regions and are frequently extrapolated to the thoracic spine, despite anatomical and biomechanical differences. PURPOSE: To evaluate whether lumbar QCT thresholds are transferable to the thoracic spine and to derive provisional thoracic-equivalent thresholds for anatomically defined thoracic subregions by statistical translation of established lumbar American College of Radiology (ACR) thresholds.
methodsIn this retrospective single-center quantitative computed tomography (QCT) study, trabecular volumetric bone mineral density (vBMD, mg/cm
resultsThoracic vBMD was significantly higher than lumbar vBMD (102.5 ± 44.1 vs. 85.1 ± 44.6 mg/cm
conclusionThoracic vBMD showed a systematic regional offset and substantial cranio-caudal variation. Because the vertebral-level composition of the overall Th1-Th10 mean varied between patients, the overall conversion should not be interpreted as a fixed anatomical thoracic threshold. The anatomically defined subregional values should be regarded as provisional thoracic-equivalent thresholds derived from lumbar ACR criteria and require prospective outcome-based validation before clinical implementation.
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