Objective: The clinical value of spinal quantitative CT (sQCT) and the structural patterns of the vertebral bone were studied.
Material and methods: sQCT was performed on 246 patients with a mean age of 57 years for whom conventional lateral radiographies of the thoracic and lumbar spine were available. All patients were suffering from back pain of unknown etiology. The bone mineral density (BMD) of the midvertebral section of 3 lumbar vertebral bodies was determined by means of single-energy-(SE)-weighted QCT (85 kV). Spongiosa architecture and density profile analyses were made in the axial images. This was contrasted to BMD values ascertained in SE QCT. The mean BMD was compared to the number of fractures and the patients were divided into three groups: group I--no fracture; group II--one fracture; and group III > 1 fracture.
Results: The mean BMD was: 134.3 (74.1-187.5) mg hydroxyapatite (HA)/ml in group I; 79.6 (58.6-114.3) mg HA/ml in group II; and 52.4 (13.1-79.1) mg HA/ml in group III. A significant deterioration in spongiosa structure was found with increasing demineralization: strongly rarefied patterns predominated in the fracture groups II and III.
Conclusion: sQCT provides a good risk assessment of the occurrence of vertebral body insufficiency fractures.