New bone density assessment may better predict poor spinal fusion outcomes

Alan Condon -   Print  |
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Researchers from New York City-based Hospital for Special Surgery are using a novel method for evaluating bone density that may be able to more accurately predict which patients would have poor outcomes after spinal fusion.

Endocrinologist and bone specialist Emily Stein, MD, led the study with spine surgeons Han Jo Kim, MD, Matthew Cunningham MD, PhD, and Frank Schwab, MD.

The study used high-resolution peripheral quantitative computed tomography to measure bone quality in patients undergoing spinal fusion, as opposed to the more traditional method of X-ray absorptiometry.

"DXA provides a two-dimensional measure of bone density, or the amount of bone present, whereas HR-pQCT provides a true three-dimensional measurement of the bone density," Dr. Stein said in a Dec. 14 news release. "This provides additional information about the structural features of bone that can be leading to weakness or fragility."

The study took DXA and HR-pQCT scans of the radius and leg bone in 54 men and women undergoing spinal fusion between December 2017 and December 2019.

Fourteen patients had complications within the first six months of surgery, including broken rods, loosened bone screws, fractures and abnormal bending of the spine. 

But researchers found patients with abnormalities on HR-pQCT were more likely to have complications than those without such defects, abnormalities not evident using DXA. Abnormalities included lower bone mineral density in the trabeculae, fewer and thinner trabeculae and thinner cortices.

Researchers concluded that HR-pQCT provides data that can't be seen using DXA.

The study is being expanded to a wider pool of patients, which will help "define which features, or group of features of the bone structure is most important in contributing to surgical success," Dr. Stein said.

Click here for more information on the study.

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