scholarly journals Use of co-registered high-resolution computed tomography scans before and after screw insertion as a novel technique for bone mineral density determination along screw trajectory

Bone ◽  
2009 ◽  
Vol 44 (6) ◽  
pp. 1163-1168 ◽  
Author(s):  
M.T. Sabo ◽  
S.I. Pollmann ◽  
K.R. Gurr ◽  
C.S. Bailey ◽  
D.W. Holdsworth
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
High Resolution ◽  
Bone Mineral ◽  
Mineral Density ◽  
High Resolution Computed Tomography ◽  
Screw Insertion ◽  
Novel Technique ◽  
Computed Tomography Scans ◽  
Before And After

Bone Evaluation by High-Resolution Peripheral Quantitative Computed Tomography in Patients With Adrenal Incidentaloma

2020 ◽  
Vol 105 (8) ◽  
pp. e2726-e2737
Author(s):  
Aline Barbosa Moraes ◽  
Marcela Pessoa de Paula ◽  
Francisco de Paula Paranhos-Neto ◽  
Emanuela Mello Ribeiro Cavalari ◽  
Felipe Fernandes Cordeiro de Morais ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
High Resolution ◽  
Distal Radius ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Adrenal Incidentaloma ◽  
Peripheral Quantitative Computed Tomography ◽  
Mineral Density ◽  
X Ray

Abstract Context Data regarding high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with adrenal incidentaloma (AI) are unknown. Purpose To evaluate the areal bone mineral density (aBMD), microstructure, and fractures in patients with nonfunctioning AI (NFAI) and autonomous cortisol secretion (ACS). Methods We evaluated 45 patients with NFAI (1 mg dexamethasone suppression test [DST] ≤1.8 µg/dL) and 30 patients with ACS (1 mg DST 1.9-5.0 µg/dL). aBMD was measured using dual-energy X-ray absorptiometry; vertebral fracture by spine X-ray; and bone geometry, volumetric bone mineral density (vBMD), and microstructure by HR-pQCT. Results Patients with ACS showed lower aBMD values at the spine, femoral neck, and radius 33% than those with NFAI. Osteoporosis was frequent in both groups: NFAI (64.9%) and ACS (75%). Parameters at the distal radius by HR-pQCT were decreased in patients with ACS compared to those with NFAI: trabecular vBMD (Tb.vBMD, P = 0.03), inner zone of the trabecular region (Inn.Tb.vBMD, P = 0.01), the bone volume/tissue volume ratio (BV/TV, P = 0.03) and trabecular thickness (P = 0.04). As consequence, a higher ratio of the outer zone of the trabecular region/inner zone vBMD (Meta/Inn.vBMD, P = 0.003) was observed. A correlation between the cortisol levels after 1 mg DST and Meta/Inn.vBMD ratio was found (r = 0.29; P = 0.01). The fracture frequency was 73.7% in patients with ACS vs 55.6% in patients with NFAI (P = 0.24). Conclusion Our findings point to an association between trabecular bone microarchitectural derangement at the distal radius and ACS. Our data suggest that AI have a negative impact on bone when assessed by HR-pQCT, probably associated to subclinical hypercortisolism.

scholarly journals Correlation between the Computed Tomography Values of the Screw Path and Pedicle Screw Pullout Strength: An Experimental Study in Porcine Vertebrae

2020 ◽  
Vol 14 (3) ◽  
pp. 265-272
Author(s):  
Atsushi Ikeura ◽  
Taketoshi Kushida ◽  
Kenichi Oe ◽  
Yoshihisa Kotani ◽  
Muneharu Ando ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Pedicle Screw ◽  
Bone Mineral ◽  
Lumbar Vertebrae ◽  
Pedicle Screws ◽  
Mineral Density ◽  
Screw Insertion ◽  
Pull Out ◽  
Pull Out Strength

Study Design: Biomechanical study.Purpose: To assess the correlation between the computed tomography (CT) values of the pedicle screw path and screw pull-out strength.Overview of Literature: The correlation between pedicle screw pull-out strength and bone mineral density has been well established. In addition, several reports have demonstrated a correlation between bone mineral density and CT values. However, no previous biomechanical studies investigated the correlation between CT values and pedicle screw pull-out strength.Methods: Sixty fresh-frozen lumbar vertebrae from 6-month-old pigs were used. Before screw insertion, the CT values of the screw path were obtained for each sample. Specimens were then randomly divided into three equal groups. Each group had one of three pedicle screws inserted: 4.0-mm LEGACY (4.0-LEG), 4.5-mm LEGACY (4.5-LEG), or 4.5-mm SOLERA (4.5-SOL) (all from Medtronic Sofamor Danek Inc., Memphis, TN, USA). Each screw had a consistent 30-mm thread length. Axial pull-out testing was performed at a rate of 1.0 mm/min. Correlations between the CT values and pedicle screw pull-out strength were evaluated using Pearson’s correlation coefficient analysis.Results: The correlation coefficients between the CT values of the screw path and pedicle screw pull-out strength for the 4.0-LEG, 4.5-LEG, and 4.5-SOL groups were 0.836 (<i>p</i> <0.001), 0.780 (<i>p</i> <0.001), and 0.873 (<i>p</i> <0.001), respectively. Greater CT values were associated with greater screw pull-out strength.Conclusions: The CT values of the screw path were strongly positively correlated with pedicle screw pull-out strength, regardless of the screw type and diameter, suggesting that the CT values could be clinically useful for predicting pedicle screw pull-out strength.

scholarly journals Bone microstructural changes revealed by high-resolution peripheral quantitative computed tomography imaging and elevated DKK1 and MIP-1α levels in patients with MGUS

Blood ◽  
2011 ◽  
Vol 118 (25) ◽  
pp. 6529-6534 ◽  
Author(s):  
Alvin C. Ng ◽  
Sundeep Khosla ◽  
Natthinee Charatcharoenwitthaya ◽  
Shaji K. Kumar ◽  
Sara J. Achenbach ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
High Resolution ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Trabecular Thickness ◽  
Increased Risk

Abstract Recent population-based studies demonstrate an increased fracture risk with monoclonal gammopathy of undetermined significance (MGUS). The etiology of this increased risk remains unclear, however, because areal bone mineral density (aBMD) measurements by dual-energy x-ray absorptiometry cannot assess bone microstructural properties critical to determining bone quality and strength. To better define the skeletal effects of MGUS, we performed aBMD and high-resolution peripheral quantitative computed tomography volumetric bone mineral density (vBMD) measurements in 50 MGUS patients (20 females, 30 males; mean ± SEM age, 70.5 ± 1.4 years) and 100 matched control subjects. Relative to controls, MGUS patients had decreased aBMD at the femoral neck (P = .05) and total femur (P < .05) but no differences at other sites. In contrast, high-resolution peripheral quantitative computed tomography showed markedly diminished cortical thickness (P < .05) and increased endocortical area (P < .01). Average vBMD (P < .01), cortical vBMD (P < .001), and trabecular thickness (P < .01) were all significantly decreased in MGUS patients, suggestive of impaired bone formation. Serum levels of the Wnt pathway inhibitor Dickkopf-related protein 1 (P < .001) and osteoclast-activating factor MIP-1α (P < .05) also were significantly elevated in MGUS patients. Our data provide the first evidence of altered bone microstructure in MGUS and suggest that cytokines elevated in osteolytic myeloma also may be associated with bone loss in MGUS.

Bone density and its relation to the development of acromial stress fracture following reverse total shoulder arthroplasty

2020 ◽  
pp. 175857322094999
Author(s):  
Shawn T Yeazell ◽  
Jordan Inacio ◽  
Ajith Malige ◽  
Hannah Dailey ◽  
Gregory F Carolan
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Stress Fracture ◽  
Bone Mineral ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Region Of Interest ◽  
Volumetric Bone Mineral Density ◽  
Mineral Density ◽  
Computed Tomography Scans

Background Postoperative acromial stress fracture is a troublesome postoperative complication after reverse shoulder arthroplasty. Our study aims to utilize routinely performed preoperative computed tomography scans to identify differences in the material properties of the acromion in patients who did and did not develop a postoperative acromial stress fracture. Methods Treatment records and computed tomography scans for 99 reverse shoulder arthroplasties were collected. Scans were calibrated using a phantom and transferred for post-processing where the acromion, full scapula, and humeral head were isolated. The final segmented model was used to assess acromial volume and volumetric bone mineral density for each region of interest. Results There was no association between age and volumetric bone mineral density in any region of interest (all R2 ≤ 0.048, all p > 0.082). Patients who developed an acromial stress fracture were not significantly different from those who did not in terms of age, acromial volume, or acromial volumetric bone mineral density (all p > 0.559). Patients with known osteoporosis or osteopenia had slightly lower volumetric bone mineral density, but the differences were not significant (all p ≥ 0.072). Conclusion Postoperative acromial fractures following reverse shoulder arthroplasty cannot be predicted by computed tomography-derived volumetric bone mineral density or volume. These mechanical characteristics also do not predictably decrease with age or osteoporosis diagnosis.

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