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Evaluation of bone mineral density after instrumented lumbar fusion with computed tomography

医学 霍恩斯菲尔德秤 腰椎 核医学 腰椎 脊柱融合术 放射科 工件(错误) 计算机断层摄影术 神经科学 生物
作者
Nathan Wanderman,Steven D. Glassman,Tino Mkorombindo,John R. Dimar,Jeffrey L. Gum,Leah Y. Carreon
出处
期刊:The Spine Journal [Elsevier BV]
卷期号:22 (6): 951-956 被引量:7
标识
DOI:10.1016/j.spinee.2022.02.007
摘要

Computed tomography (CT) measurement of Hounsfield Units (HU) has been described as a tool for assessing BMD. For surgeons considering a revision lumbar fusion, knowledge of the BMD of the UIV is of value for surgical planning. However, the presence of metal artifact from instrumentation presents a potential confounder, and prior studies have not validated measurements of HU in this setting.To determine if HU can be measured reliably at the supra-adjacent and upper instrumented levels of a lumbar fusion.Retrospective observational cohort PATIENT SAMPLE: Consecutive series of patients who had lumbar CT scans after an instrumented posterior lumbar fusion.Hounsfield Units at the upper instrumented vertebra and levels proximal.We analysed pre- and postoperative CT scans of 50 patients who underwent L2 and distal instrumented lumbar fusion whose scans were no greater than 1 year apart, obtaining HU measurements of analogous axial cuts at the upper instrumented level (immediately caudal to the halo of the pedicle screw), as well as additional control levels above the construct.The HU at the pre-and postoperative UIV exhibited a strong correlation (r=0.917, p<.001), as did one (r=0.887, p<.001) and two (r=0.853, p<.001) levels above the UIV. There were significant but predictable reductions in the postoperative HU compared to preoperative at one (-9.0±26.2) and two (-12.2±30.2) levels above the UIV, as well as T12 (-13.9±42.2). There was no significant difference in HU at the UIV (4.6±34.1).Postoperative HU at the UIV was strongly correlated with and not significantly different from the preoperative HU. Although the HU in the vertebrae proximal to the UIV were slightly lower postoperatively, this change was predictable using a correction factor.
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