Forearm bone mineral density predicts screw loosening after lumbar fusion similar to lumbar Hounsfield unit value in patients with lumbar spondylolisthesis
Authors' conclusion
The forearm BMD was an independent risk factor for loosening of the lumbar pedicle screws. The forearm BMD was a valid predictor of pedicle screw loosening in patients undergoing lumbar fusion, as was the CT HU value.
Study context
- Population
- Patients who underwent posterior lumbar interbody fusion for lumbar spondylolisthesis
- Participants
- 270 patients
- Exposure
- Screw loosening vs non-loosening; forearm bone mineral density (BMD) (DXA) vs lumbar CT Hounsfield unit (HU) value as predictors
- Outcome
- Pedicle screw loosening
- Follow-up
- Minimum 12 months
Main finding
As reported in the abstract
Forearm BMD
Loosening
0.461
average · ± 0.1
Non-loosening
0.577
average · ± 0.1
P < 0.001
- Forearm BMD independent risk factor for screw loosening (multivariate logistic regression), OR
- 0.840 (95%CI 0.797-0.886)
- Forearm BMD AUC for predicting screw loosening
- 0.802
- Forearm BMD cut-off for predicting screw loosening
- 0.543 (sensitivity 0.800; specificity 0.864)
Observational data: associations, not effects.
Further findings
| Outcome | Loosening | Non-loosening | P value |
|---|---|---|---|
| Mean HU value (L1-4)Lower in loosening | mean 121.1 ± 27.3 | mean 155.6 ± 32.2 | P < 0.001 |
- Mean HU value (L1-4) — HU value (L1-4) independent risk factor for screw loosening, OR
- 0.952 (95%CI 0.935-0.969)
- Mean HU value (L1-4) — HU value AUC for predicting screw loosening
- 0.811
Screw loosening rate · minimum 12 months follow-up
- Rate of screw loosening
- 13%
Original publication
Forearm bone mineral density predicts screw loosening after lumbar fusion similar to lumbar Hounsfield unit value in patients with lumbar spondylolisthesis. Osteoporos Int. Published 3 November 2023. doi:10.
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