OBJECTIVES: To evaluate quantitative dual-energy computed tomography (DECT) for phantomless analysis of cancellous bone mineral density (BMD) of vertebral pedicles and to assess the correlation with pedicle screw pull-out strength. METHODS: Twenty-nine thoracic and lumbar vertebrae from cadaver specimens were examined with DECT. Using dedicated post-processing software, a pedicle screw vector was mapped (R1, intrapedicular segment of the pedicle vector; R2, intermediate segment; R3, intracorporal segment; global, all segments) and BMD was calculated. To invasively evaluate pedicle stability, pedicle screws were drilled through both pedicles and left pedicle screw pull-out strength was measured. Resulting values were correlated using the paired t test and Pearson's linear correlation. RESULTS: Average pedicle screw vector BMD (R1, 0.232 g/cm(3); R2, 0.166 g/cm(3); R3, 0.173 g/cm(3); global, 0.236 g/cm(3)) showed significant differences between R1-R2 (P < 0.002) and R1-R3 (P < 0.034) segments while comparison of R2-R3 did not reach significance (P > 0.668). Average screw pull-out strength (639.2 N) showed a far stronger correlation with R1 (r = 0.80; P < 0.0001) than global BMD (r = 0.42; P = 0.025), R2 (r = 0.37; P = 0.048) and R3 (r = -0.33; P = 0.078) segments. CONCLUSIONS: Quantitative DECT allows for phantomless BMD assessment of the vertebral pedicle. BMD of the intrapedicular segment shows a significantly stronger correlation with pedicle screw pull-out strength than other segments. KEY POINTS: • Quantitative dual-energy CT enables evaluation of pedicle bone mineral density. • Intrapedicular segments show significant differences regarding bone mineral density. • Pedicle screw pull-out strength correlated strongest with R1 values. • Dual-energy CT may improve preoperative assessment before transpedicular screw fixation.
OBJECTIVES: To evaluate quantitative dual-energy computed tomography (DECT) for phantomless analysis of cancellous bone mineral density (BMD) of vertebral pedicles and to assess the correlation with pedicle screw pull-out strength. METHODS: Twenty-nine thoracic and lumbar vertebrae from cadaver specimens were examined with DECT. Using dedicated post-processing software, a pedicle screw vector was mapped (R1, intrapedicular segment of the pedicle vector; R2, intermediate segment; R3, intracorporal segment; global, all segments) and BMD was calculated. To invasively evaluate pedicle stability, pedicle screws were drilled through both pedicles and left pedicle screw pull-out strength was measured. Resulting values were correlated using the paired t test and Pearson's linear correlation. RESULTS: Average pedicle screw vector BMD (R1, 0.232 g/cm(3); R2, 0.166 g/cm(3); R3, 0.173 g/cm(3); global, 0.236 g/cm(3)) showed significant differences between R1-R2 (P < 0.002) and R1-R3 (P < 0.034) segments while comparison of R2-R3 did not reach significance (P > 0.668). Average screw pull-out strength (639.2 N) showed a far stronger correlation with R1 (r = 0.80; P < 0.0001) than global BMD (r = 0.42; P = 0.025), R2 (r = 0.37; P = 0.048) and R3 (r = -0.33; P = 0.078) segments. CONCLUSIONS: Quantitative DECT allows for phantomless BMD assessment of the vertebral pedicle. BMD of the intrapedicular segment shows a significantly stronger correlation with pedicle screw pull-out strength than other segments. KEY POINTS: • Quantitative dual-energy CT enables evaluation of pedicle bone mineral density. • Intrapedicular segments show significant differences regarding bone mineral density. • Pedicle screw pull-out strength correlated strongest with R1 values. • Dual-energy CT may improve preoperative assessment before transpedicular screw fixation.
Authors: Narayan Yoganandan; Frank A Pintar; Brian D Stemper; Jamie L Baisden; Recyi Aktay; Barry S Shender; Glenn Paskoff; Purushottam Laud Journal: Bone Date: 2006-03-31 Impact factor: 4.398
Authors: Klaus Engelke; Judith E Adams; Gabriele Armbrecht; Peter Augat; Cesar E Bogado; Mary L Bouxsein; Dieter Felsenberg; Masako Ito; Sven Prevrhal; Didier B Hans; E Michael Lewiecki Journal: J Clin Densitom Date: 2008 Jan-Mar Impact factor: 2.617
Authors: Ronald A Lehman; Melvin D Helgeson; Anton E Dmitriev; Haines Paik; Adam J Bevevino; Rachel Gaume; Daniel G Kang; Lawrence G Lenke Journal: Spine (Phila Pa 1976) Date: 2012-09-01 Impact factor: 3.468
Authors: Tommaso D'Angelo; Giuseppe Cicero; Silvio Mazziotti; Giorgio Ascenti; Moritz H Albrecht; Simon S Martin; Ahmed E Othman; Thomas J Vogl; Julian L Wichmann Journal: Br J Radiol Date: 2019-04-09 Impact factor: 3.039
Authors: Kai Mei; Benedikt J Schwaiger; Felix K Kopp; Sebastian Ehn; Alexandra S Gersing; Jan S Kirschke; Daniela Muenzel; Alexander A Fingerle; Ernst J Rummeny; Franz Pfeiffer; Thomas Baum; Peter B Noël Journal: Sci Rep Date: 2017-12-13 Impact factor: 4.379
Authors: Robbert W van Hamersvelt; Arnold M R Schilham; Klaus Engelke; Annemarie M den Harder; Bart de Keizer; Harald J Verhaar; Tim Leiner; Pim A de Jong; Martin J Willemink Journal: Eur Radiol Date: 2017-04-03 Impact factor: 5.315
Authors: Vitali Koch; Nils Große Hokamp; Moritz H Albrecht; Leon D Gruenewald; Ibrahim Yel; Jan Borggrefe; Stefan Wesarg; Katrin Eichler; Iris Burck; Tatjana Gruber-Rouh; Lukas Lenga; Thomas J Vogl; Simon S Martin; Julian L Wichmann; Renate M Hammerstingl; Leona S Alizadeh; Christoph Mader; Nicole A Huizinga; Tommaso D'Angelo; Giorgio Ascenti; Silvio Mazziotti; Christian Booz Journal: Eur Radiol Exp Date: 2021-10-05