Application of an MRI-based Lumbar Vertebral Bone Quality Scoring System in Patients with Degenerative Lumbar Scoliosis

Although dual-energy X-ray absorptiometry (DXA) is still the gold standard for diagnosing osteoporosis, it can lead to inaccurate bone mineral density (BMD) measurements due to lumbar degeneration and scoliosis. Many researchers have investigated diagnostic methods for osteoporosis in patients with degenerative lumbar scoliosis (DLS). This study aimed to investigate the differences between conventional vertebral bone quality (VBQ) scores and modified VBQ scores in patients with DLS and the influence of lumbar scoliosis on VBQ scores. We retrospectively collected the clinical and radiological data of 68 patients with DLS admitted to Sun Yat-sen Memorial Hospital from July 2018 to April 2023. The patients were classified into one of two groups based on the T score of the left femoral neck. VBQ scores relative to cerebrospinal fluid (CSF) at different levels, VBQ scores on different planes and single-level VBQ scores were compared. Receiver operating characteristic (ROC) analysis was also performed. Different modified VBQ scores were compared between the moderate scoliosis group (10°≤Cobb angle<20°) and the severe scoliosis group (Cobb angle≥20°). There were no significant differences in VBQ scores relative to CSF at different levels (p=0.983), on different planes (p=0.832) or at single-level (p=0.996). All the VBQ scores were negatively correlated with the T score of the left femoral neck. There were no significant differences in the modified VBQ scores between the moderate and severe scoliosis groups. Different modified VBQ scores can be used as supplementary methods for diagnosing osteoporosis in patients with DLS. Lumbar scoliosis may not significantly affect the VBQ score.