Assessing underlying bone quality in spine surgery patients: a narrative review of dual-energy X-ray absorptiometry (DXA) and alternatives

被引:63
作者
Pennington, Zach [1 ]
Ehresman, Jeff [1 ]
Lubelski, Daniel [1 ]
Cottrill, Ethan [1 ]
Schilling, Andrew [1 ]
Ahmed, A. Karim [1 ]
Feghali, James [1 ]
Witham, Timothy F. [1 ]
Sciubba, Daniel M. [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Neurosurg, 600 N Wolfe St,Meyer 5-185A, Baltimore, MD 21205 USA
基金
美国国家卫生研究院;
关键词
Bone mineral density; Compression fracture; Dual-energy X-ray absorptiometry; DXA; Osteoporosis; quantitative computed tomography; preoperative evaluation;
D O I
10.1016/j.spinee.2020.08.020
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Poor bone quality and low bone mineral density (BMD) have been previously tied to higher rates of postoperative mechanical complications in patients undergoing spinal fusion. These include higher rates of proximal junctional kyphosis, screw pullout, pseudoarthrosis, and interbody subsidence. For these reasons, accurate preoperative assessment of a patient's underlying bone quality is paramount for all elective procedures. Dual-energy X-ray absorptiometry (DXA) is currently considered to be the gold standard for assessing BMD. However, a growing body of research has suggested that in vivo assessments of BMD using DXA are inaccurate and have, at best, moderate correlations to postoperative mechanical complications. Consequently, there have been investigations into using alternative methods for assessing in vivo bone quality, including using computed tomography (CT) and magnetic resonance imaging (MRI) volumes that are commonly obtained as part of surgical evaluation. Here we review the data regarding the accuracy of DXA for the evaluation of spine bone quality and describe the alternative imaging modalities currently under investigation. (C) 2020 Elsevier Inc. All rights reserved.
引用
收藏
页码:321 / 331
页数:11
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