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Assessing the Impact of Preoperative MRI-Based Vertebral Bone Quality Scores on Five-Year Prognosis in Lumbar Spine
Hiroshi Taniwaki1, Masatoshi Hoshino1, Yuki Kinoshita1
1Department of Orthopedic Surgery, Osaka City General Hospital, Osaka, Japan.
Spine
|May 16, 2024
Summary
High vertebral bone quality (VBQ) scores predict poor five-year outcomes in lumbar spine surgery patients. This MRI-based assessment aids in osteoporotic screening and predicting surgical success.
Area of Science:
- Orthopedics
- Spine Surgery
- Radiology
Background:
- Osteoporosis is a concern for older adults undergoing spinal surgery.
- Vertebral bone quality (VBQ) scores from MRI correlate with fractures and complications.
- Impact of VBQ on mid-term lumbar surgery outcomes is not well-established.
Purpose of the Study:
- To evaluate the predictive value of preoperative VBQ scores for five-year clinical outcomes after lumbar spine surgery.
Main Methods:
- Retrospective cohort study of 189 patients undergoing lumbar surgery for spinal stenosis.
- Patients categorized into high, middle, and low VBQ score groups.
- Clinical outcomes assessed using JOABPEQ and SF-36 questionnaires over five years.
Main Results:
- Significant differences in low back pain, walking ability, social function, and physical health were observed across VBQ groups.
- Higher VBQ scores correlated with worse five-year postoperative outcomes in most domains.
- Adjusted regression analysis confirmed VBQ score as a predictor of outcomes.
Conclusions:
- Preoperative VBQ score is a significant risk factor for poor five-year clinical outcomes post-lumbar surgery.
- VBQ assessment via MRI offers a cost-effective, radiation-free method for osteoporotic screening.
- VBQ score shows potential as a prognostic indicator for surgical outcomes.
