@article{b152e01d9c5b48bab0a3349528b809e2,
title = "Assessing underlying bone quality in spine surgery patients: a narrative review of dual-energy X-ray absorptiometry (DXA) and alternatives",
abstract = "Poor bone quality and low bone mineral density (BMD) have been previously tied to higher rates of postoperative mechanical complications in patients undergoing spinal fusion. These include higher rates of proximal junctional kyphosis, screw pullout, pseudoarthrosis, and interbody subsidence. For these reasons, accurate preoperative assessment of a patient's underlying bone quality is paramount for all elective procedures. Dual-energy X-ray absorptiometry (DXA) is currently considered to be the gold standard for assessing BMD. However, a growing body of research has suggested that in vivo assessments of BMD using DXA are inaccurate and have, at best, moderate correlations to postoperative mechanical complications. Consequently, there have been investigations into using alternative methods for assessing in vivo bone quality, including using computed tomography (CT) and magnetic resonance imaging (MRI) volumes that are commonly obtained as part of surgical evaluation. Here we review the data regarding the accuracy of DXA for the evaluation of spine bone quality and describe the alternative imaging modalities currently under investigation.",
keywords = "Bone mineral density, Compression fracture, DXA, Dual-energy X-ray absorptiometry, Osteoporosis, preoperative evaluation, quantitative computed tomography",
author = "Zach Pennington and Jeff Ehresman and Daniel Lubelski and Ethan Cottrill and Andrew Schilling and Ahmed, {A. Karim} and James Feghali and Witham, {Timothy F.} and Sciubba, {Daniel M.}",
note = "Funding Information: Author disclosures: ZP: Nothing to disclose. JE: Nothing to disclose. DL: Nothing to disclose. EC: Grants: National Institute on Aging, National Institute of Health – F30 grant (F). AS: Nothing to disclose. AKA: Nothing to disclose. JF: Nothing to disclose. TFW: Stock Ownership: Augmedics (B); Consulting: DePuy Synthes (B); Speaking and/or Teaching Arrangements: AO Spine North America (B); Scientific Advisory Board/Other Office: Augmedics (B); Grants: Gordon and Marilyn Macklin Foundation (G), Eli Lilly and Company (C). DMS: Consulting: Baxter Medical (C), DePuy Synthes (D), Ethicon (B), Globus (B), K2M (C), Medical Devices (E), Medtronic (C), NuVasive (B), Stryker (F); Trips/Travel: Baxter (A), DePuy Synthes (B), Globus (B), K2M (B), Medical Devices, Inc (C), Medicrea (B), Medtronic (C), NuVasive (B), Stryker (C), Synthes (C); Grants: Baxter Medical (D), Stryker (E). Funding Information: Author disclosures: ZP : Nothing to disclose. JE : Nothing to disclose. DL : Nothing to disclose. EC : Grants: National Institute on Aging, National Institute of Health – F30 grant (F). AS : Nothing to disclose. AKA : Nothing to disclose. JF : Nothing to disclose. TFW : Stock Ownership: Augmedics (B); Consulting: DePuy Synthes (B); Speaking and/or Teaching Arrangements: AO Spine North America (B); Scientific Advisory Board/Other Office: Augmedics (B); Grants: Gordon and Marilyn Macklin Foundation (G), Eli Lilly and Company (C). DMS : Consulting: Baxter Medical (C), DePuy Synthes (D), Ethicon (B), Globus (B), K2M (C), Medical Devices (E), Medtronic (C), NuVasive (B), Stryker (F); Trips/Travel: Baxter (A), DePuy Synthes (B), Globus (B), K2M (B), Medical Devices, Inc (C), Medicrea (B), Medtronic (C), NuVasive (B), Stryker (C), Synthes (C); Grants: Baxter Medical (D), Stryker (E). Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",
year = "2021",
month = feb,
doi = "10.1016/j.spinee.2020.08.020",
language = "English (US)",
volume = "21",
pages = "321--331",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "2",
}