Could the Trabecular Bone Score Be a Complementary Tool for Evaluating Degenerative Lumbar Vertebrae?

Area of Science:

• Gerontology
• Radiology
• Orthopedics

Background:

• Assessing bone mass and quality in elderly individuals is complicated by degenerative spinal changes.
• Trabecular bone score (TBS) and Hounsfield units (HU) are potential metrics for bone evaluation.

Purpose of the Study:

• To evaluate the utility of TBS and HU in assessing vertebral bone quality in the elderly.
• To examine the relationship between bone mineral density (BMD), TBS, and HU values in the presence of degenerative changes.

Main Methods:

• Retrospective analysis of 599 vertebrae from 152 patients (mean age 69.0 years).
• Calculation of TBS from DXA images and measurement of HU values from CT scans.
• Categorization of vertebrae into three grades based on degeneration and statistical analysis using ANOVA and Pearson's correlation.

Main Results:

• Lumbar BMD significantly increased with degenerative changes (p<0.01), but TBS and HU values did not show significant differences.
• Correlations between BMD and TBS/HU were stronger in non-degenerated vertebrae compared to degenerated ones.
• Severe degeneration, especially with sclerosis, impacted HU values, showing significant differences between vertebral sides.

Conclusions:

• TBS demonstrates greater potential than HU as a complementary tool for evaluating vertebral bone quality in the elderly.
• Degenerative changes can affect the reliability of HU measurements, highlighting the advantage of TBS.