Vertebral Bone Quality Score as a Predictor of Subsequent Fractures After Cement Augmentation for Osteoporotic Vertebral Compression Fracture

Dual-energy X-ray absorptiometry (DXA) T -scores have been shown to predict fragility fractures in population-based studies. Recently, a novel MRI-based vertebral bone quality (VBQ) score has been proposed, showing better predictability for fragility fractures compared with DXA T -scores. The aim of this study was to explore the correlation between VBQ scores and DXA T -scores and to determine the impact of VBQ scores on the risk of subsequent fragility fractures after cement augmentation for osteoporotic vertebral compression fracture (OVCF). Between January and December 2018, 251 consecutive patients who received cement augmentation for OVCF were included in the study. VBQ scores were calculated using noncontrast T1-weighted MRI. Correlations between VBQ and T -scores were assessed. Patients were divided into 2 groups based on the presence or absence of subsequent fragility fractures after cement augmentation: (1) no Subsequent fracture group and (2) subsequent fracture group. Comparisons between the groups were conducted, and risk factors of subsequent fractures were evaluated using multivariable logistic regression analysis. Of the patients, 42 (16.7%) experienced subsequent fractures after cement augmentation. The VBQ score showed moderate correlations with the T -score of the hip (r = -0.523, P < .001) and the T -score of the lumbar spine (r = -0.383, P < .001). The subsequent fracture group had a significantly higher VBQ score (4.02 ± 0.56 vs 3.52 ± 0.62, P < .001) and a worse T -score of hip (-3.06 ± 1.28 vs -2.42 ± 0.98, P = .004). In the multivariable analysis, the VBQ score was the only independent predictor of subsequent fractures with 2.799 odds ratio (1.342 to 5.841, P = .006). In patients who received cement augmentation for OVCF, the VBQ score is significantly correlated with the DXA T -score and may be a more reliable predictor of subsequent fragility fractures.