ArticleAsian spine journal2024
Hounsfield units and vertebral bone quality score for predicting mechanical complications after adult spinal deformity surgery: a systematic review and meta-analysis.
Article in Asian spine journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Research trends, hotspots, and thematic evolution in scoliosis and osteoporosis: a bibliometric mapping review.Frontiers in surgery · 2026Pooled it
- Risk Factors for Proximal Junctional Kyphosis in Osteoporotic Versus Non-Osteoporotic Patients After Adult Spinal Deformity Surgery.Journal of clinical medicine · 2026Article
- Bone quality and biologic enhancers for spinal fusion in osteoporosis: a narrative review.Asian spine journal · 2026Article
- Effect of the Hybrid Screw Insertion Technique Using Pedicle and Laminar Screws at the Upper Instrumented Vertebra for Preventing Proximal Junctional Kyphosis.Global spine journal · 2026Article
- Utility of the vertebral bone quality (VBQ) score and CT hounsfield unit for bone mineral density assessment in patients with isthmic spondylolisthesis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Osteoporosis prediction using lumbar CT Hounsfield units: comparative performance and clinical implications of seven machine learning models.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Proximal junctional kyphosis and failure risk around the thoracolumbar junction: Impact of anterior malalignment, pelvic retroversion, and upper instrumented level selection.Brain & spine · 2026Article
- Risk factors analysis for refracture after vertebroplasty in osteoporotic thoracolumbar vertebral fractures.European journal of medical research · 2025Article
- Application of deformity principles in the management of spinal neoplasms: A Primer.North American Spine Society journal · 2025Article
- Article
- Bone regeneration using moldable calcium phosphate with and without recombinant human BMP-2 in a rabbit critical-sized metaphyseal core defect model.Journal of orthopaedic surgery and research · 2025Article
- An improved method for measuring the hounsfield units of the vertebral body and pedicles in patients with lumbar degenerative diseases.Neurosurgical review · 2025Article
- Article
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Abstract
The purpose of this systematic review and meta-analysis is to assess existing literature and determine the association between the Hounsfield unit (HU) value and the vertebral body quality (VBQ) score with mechanical complications (MCs) after adult spinal deformity (ASD) surgery. Although bone quality is considered an increasingly important factor for MCs after ASD surgery, the utility of the HU value assessed by computed tomography and the VBQ score assessed by magnetic resonance imaging remains unknown. A systematic review of PubMed, Embase, and Cochrane Library databases was performed to find studies evaluating the association between the HU value and the VBQ score with MCs after ASD surgery. In the subsequent meta-analysis, MC outcomes were combined using a random-effects model, and the standardized mean difference and 95% confidence interval were calculated. The final analysis included a total of 20 studies. Nineteen studies reported HU values, and two studies reported VBQ scores. Proximal junctional kyphosis/failure (PJK/PJF) was reported as the MC in 16 studies, whereas other MCs were included in 6 studies. Six studies with a pool of 506 patients with ASD revealed that preoperative HU values at the upper instrumented vertebra (UIV) and UIV+1 were significantly lower in patients with PJK/PJF (standardized mean difference, -0.74; 95% confidence interval, -1.09 to -0.40). Three studies suggested an cutoff HU value of approximately ≤120, yielding a pooled sensitivity of 0.77, specificity of 0.67, and diagnostic odds ratio of 7.01. However, two studies reported conflicting results on the relationship between the VBQ score and PJK/PJF. Low HU values predicted the risk of certain MCs, particularly PJK/PJF, after ASD surgery. An HU value of <120 should alert surgeons to be cautious about the postoperative occurrence of PJK/PJF. Future studies are needed to validate the cutoff HU value and evaluate the utility of the VBQ score.
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