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Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine

We evaluated the feasibility of using the Hounsfield unit (HU) value of the vertebral body to predict screw loosening in the thoracic spine. Consecutive patients who underwent thoracic spinal fusion surgery (from 2014 to 2020) were retrospectively identified. Patients with pedicle screw loosening in...

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Autores principales: Lee, Minsu, Lee, Eugene, Lee, Joon Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9622837/
https://www.ncbi.nlm.nih.gov/pubmed/36316434
http://dx.doi.org/10.1038/s41598-022-23142-8
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author Lee, Minsu
Lee, Eugene
Lee, Joon Woo
author_facet Lee, Minsu
Lee, Eugene
Lee, Joon Woo
author_sort Lee, Minsu
collection PubMed
description We evaluated the feasibility of using the Hounsfield unit (HU) value of the vertebral body to predict screw loosening in the thoracic spine. Consecutive patients who underwent thoracic spinal fusion surgery (from 2014 to 2020) were retrospectively identified. Patients with pedicle screw loosening in the upper instrumented vertebra (UIV) on postoperative computed tomography were included in the “loosening” group. The control group comprised an equal number of age-, sex-, and UIV-matched patients without screw loosening. Preoperative HU values at the UIV and lumbar T-scores were compared between the groups; receiver operating characteristic curves were constructed for HU values and T-scores to predict screw loosening, and the best cutoff values were determined. The same statistical analyses were performed for each subgroup, i.e., upper (T1–T4) and lower (T9–T12) thoracic levels. Forty-six patients each were included in the loosening and control groups. A significant between-group difference of HU values was noted for the lower thoracic UIV (loosening = 99.3, control = 126.3; p = 0.02) but not for the upper thoracic UIV (loosening = 171.8, control = 146.0, p = 0.70). T-scores did not differ between the groups for the lower (p = 0.14) and upper (p = 0.56) thoracic UIV. For the lower thoracic UIV, the area under the receiver operating characteristic curve was 0.660 for HUs (p = 0.01; 95% confidence interval [CI] 0.541–0.766) and 0.601 (p = 0.13; 95% CI 0.480–0.713) for T-scores. The optimal cutoff value for HUs was 126.3. Using this cutoff, HU values showed a better positive predictive value, negative predictive value, and accuracy compared to T-scores in predicting screw loosening.
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spelling pubmed-96228372022-11-02 Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine Lee, Minsu Lee, Eugene Lee, Joon Woo Sci Rep Article We evaluated the feasibility of using the Hounsfield unit (HU) value of the vertebral body to predict screw loosening in the thoracic spine. Consecutive patients who underwent thoracic spinal fusion surgery (from 2014 to 2020) were retrospectively identified. Patients with pedicle screw loosening in the upper instrumented vertebra (UIV) on postoperative computed tomography were included in the “loosening” group. The control group comprised an equal number of age-, sex-, and UIV-matched patients without screw loosening. Preoperative HU values at the UIV and lumbar T-scores were compared between the groups; receiver operating characteristic curves were constructed for HU values and T-scores to predict screw loosening, and the best cutoff values were determined. The same statistical analyses were performed for each subgroup, i.e., upper (T1–T4) and lower (T9–T12) thoracic levels. Forty-six patients each were included in the loosening and control groups. A significant between-group difference of HU values was noted for the lower thoracic UIV (loosening = 99.3, control = 126.3; p = 0.02) but not for the upper thoracic UIV (loosening = 171.8, control = 146.0, p = 0.70). T-scores did not differ between the groups for the lower (p = 0.14) and upper (p = 0.56) thoracic UIV. For the lower thoracic UIV, the area under the receiver operating characteristic curve was 0.660 for HUs (p = 0.01; 95% confidence interval [CI] 0.541–0.766) and 0.601 (p = 0.13; 95% CI 0.480–0.713) for T-scores. The optimal cutoff value for HUs was 126.3. Using this cutoff, HU values showed a better positive predictive value, negative predictive value, and accuracy compared to T-scores in predicting screw loosening. Nature Publishing Group UK 2022-10-31 /pmc/articles/PMC9622837/ /pubmed/36316434 http://dx.doi.org/10.1038/s41598-022-23142-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Lee, Minsu
Lee, Eugene
Lee, Joon Woo
Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine
title Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine
title_full Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine
title_fullStr Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine
title_full_unstemmed Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine
title_short Value of computed tomography Hounsfield units in predicting pedicle screw loosening in the thoracic spine
title_sort value of computed tomography hounsfield units in predicting pedicle screw loosening in the thoracic spine
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9622837/
https://www.ncbi.nlm.nih.gov/pubmed/36316434
http://dx.doi.org/10.1038/s41598-022-23142-8
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