Focal osteoporosis defect is associated with vertebral compression fracture prevalence in a bone mineral density-independent manner.

Abstract

Focal osteoporosis defect has shown a high association with the bone fragility and osteoporotic fracture prevalence. However, no routine computed tomography (CT)-based vertebral focal osteoporosis defect measurement and its association with vertebral compression fracture (VCF) were discussed yet. This study aimed to develop a routine CT-based measurement method for focal osteoporosis defect quantification, and to assess its association with the VCF prevalence. A total of 205 cases who underwent routine CT scanning, were retrospectively reviewed and enrolled into either the VCF or the control group. The <i>focal bone mineral content loss (focal BMC loss)</i>, measured as the cumulated demineralization within bone void space, was proposed for focal osteoporosis defect quantification. Its scan-rescan reproducibility and its correlation with trabecular bone mineral density (BMD) and apparent microarchitecture parameters were evaluated. The association between <i>focal BMC loss</i> and the prevalence of VCF was studied by logistic regression. The measurement of <i>focal BMC loss</i> showed high reproducibility (RMSSD = 0.011 mm, LSC = 0.030 mm, ICC = 0.97), and good correlation with focal bone volume fraction (<i>r</i> = 0.79, <i>P</i> < 0.001), trabecular bone separation (<i>r</i> = 0.76, <i>P</i> < 0.001), but poor correlation with trabecular BMD (<i>r</i> = 0.37, <i>P</i> < 0.001). The <i>focal BMC loss</i> was significantly higher in the fracture group than the control (1.03 ± 0.13 vs. 0.93 ± 0.11 mm; <i>P</i> < 0.001), and was associated with prevalent VCF (1.87, 95% CI = 1.31-2.65, <i>P</i> < 0.001) independent of trabecular BMD level. As a surrogate measure of focal osteoporosis defect, <i>focal BMC Loss</i> independently associated with the VCF prevalence. It suggests that focal osteoporosis defect is a common manifestation that positively contributed to compression fracture risk and can be quantified with routine CT using <i>focal BMC Loss</i>.