Evidence map›Paper›PMID 42477284›Full record

ArticleSpine deformity2026

Opportunistic bone mineral density assessment in pediatric scoliosis: validating Hounsfield unit measurement from lumbar CT images.

Kosei Nagata, Koji Nakajima, Hiroyuki Nakarai, Daiki Urayama, Atsushi Yoshida, Naoto Komatsu, Hideki Nakamoto, So Kato, Yasushi Oshima, Sakae Tanaka and 3 more

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Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Kosei NagataDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan. knagata-tky@umin.ac.jp.ORCID http://orcid.org/0000-0003-4495-1134
Koji NakajimaDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Hiroyuki NakaraiDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Daiki UrayamaDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Atsushi YoshidaDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Naoto KomatsuDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Hideki NakamotoDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
So KatoDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Yasushi OshimaDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Sakae TanakaDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Hiroshi InuiDepartment of Orthopedic Surgery, Saitama Medical University Saitama Medical Center, 1981 Kamoda, Kawagoe City, Saitama, 350-0844, Japan.
Kazuo SaitaDepartment of Orthopedic Surgery, Saitama Medical University Saitama Medical Center, 1981 Kamoda, Kawagoe City, Saitama, 350-0844, Japan.
Yuki TaniguchiDepartment of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.

Funding

Japanese Society for Bone and Mineral Research Rising Star Grant 2024
6 · The paper itself

Abstract

backgroundHounsfield Units (HU) derived from CT scans are a promising bone mineral density surrogate in pediatrics, yet their reliability in patients with scoliosis and significant lumbar tilt remains unknown. We investigated the reliability of HU measurements in adolescent idiopathic scoliosis (AIS), particularly addressing the impact of spinal tilt.

methodsWe retrospectively reviewed lumbar CT images of 11- to 19-year-old AIS patients who underwent posterior spinal fusion (July 2007-March 2024). HU values and lumbar tilt were measured at L1, L3, and L5. Reliability was assessed using intra-rater (N = 36), inter-rater (N = 30), and equivalence datasets (N = 62) comparing standard pelvis-parallel images versus images reconstructed parallel to the vertebral body.

resultsBoth intra-rater (ICC(1,1) > 0.95) and inter-rater (ICC(2,1) > 0.80) reliability were excellent. Measurements from standard pelvis-parallel images and reconstructed images showed stable overall equivalence (ICC(3,1) = 0.96). However, the percentage of cases with an HU value difference of 20 or more was 11.3% when the lumbar tilt angle was 10 degrees or greater, compared to 5.6% when the tilt angle was below 9 degrees.

conclusionOur analyses for AIS patients showed that vertebral HU measurements are reliable when using vertebral-parallel reconstructed images but standard pelvis-parallel images lose reliability with significant tilt. While our findings do not promote routine CT usage, our validated methodology provides a baseline technique that could potentially be applied to complex, high-risk cases where osteoporosis is prevalent and critical for surgical planning.

Indexed as

Adolescent idiopathic scoliosisBone mineral densityHounsfield unitImage reconstructionLumbar CT

Identifiers

PMID42477284

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.