Assessment of Lumbar Vertebrae Morphology by Computed Tomography in Older Adults with Osteoporosis

Hounsfield Units (HU) values derived from Computerized Tomography (CT) have been used in the diagnosis of osteoporosis in the lumbar spine.

This study aimed to identify anatomical dimensions of lumbar vertebrae on CT images, which were different between older normal, osteopenic, and osteoporotic subjects.

This prospective pilot study enrolled 79 older adults. Based on CT measurements of lumbar vertebrae in HU, participants were classified into three groups: normal (HU > 109), osteopenia (HU: 94-108), and osteoporosis (HU < 93). Altogether, 42 anatomical variables of lumbar vertebrae, L2, L3, L4, and L5, were measured in each participant by CT, including 24 parameters measurable by MRI or plain X-ray and 18 parameters measurable by MRI only.

Among the morphological measurements also measurable by MRI and plain X-ray, the length upper curve, 50% and 75% of L5, length upper with the cortex of L4, length center of the cortex of L3, as well as width upper curve 75% of L2, were significantly different between the three groups (p= 0.008, 0.007, 0.035, 0.036, and 0.003 respectively). Among the morphological measurements also measurable by MRI, only the width upper cortex 75% of L5 and the width lower cortex 25% of L3, were significantly different between the three groups (p= 0.031 and 0.020, respectively).

Seven CT morphological measurements may be used as "reference standard" CT measurements for preliminarily diagnosing osteoporosis and osteopenia in older adults.