Efficacy Analysis of BMD，T-scores，HU Values，and Modified VBQ Scores in Predicting Thoracolumbar Fragility Fractures

Shixin XU; Rongshuang YAN; Cheng PAN; Yang LUO; Derui FEI; Quan Li; Ying ZHANG

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Shixin XU, Rongshuang YAN, Cheng PAN, Yang LUO, Derui FEI, Quan Li, Ying ZHANG. Efficacy Analysis of BMD，T-scores，HU Values，and Modified VBQ Scores in Predicting Thoracolumbar Fragility Fractures[J]. Journal of Kunming Medical University.

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Efficacy Analysis of BMD，T-scores，HU Values，and Modified VBQ Scores in Predicting Thoracolumbar Fragility Fractures

Department of Orthopedics，The Second Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2025-07-09
Available Online: 2025-08-12

Abstract

Abstract

Objective To investigate the differences in BMD, T-scores, lumbar HU values, and modified VBQ scores in patients with thoracolumbar fractures, analyze their correlations, and evaluate their predictive efficacy for thoracolumbar fractures. Methods Patients with thoracolumbar fragility fractures and hospitalized in the Department of Orthopedics at the Second Affiliated Hospital of Kunming Medical University from January 2022 to March 2025 were retrospectively enrolled. Among them, 132 eligible patients were divided into the fracture group （n = 63） and the non-fracture group （n = 69）. BMD and T-scores of L1～L4 vertebrae were measured via DEXA, lumbar HU values were obtained from CT scans, and modified VBQ scores were calculated using lumbar MRI. Intergroup comparisons were performed using independent samples t-tests. Pearson's correlation analysis was used to assess the relationships among BMD, T-scores, HU values, and modified VBQ scores. Receiver operating characteristic （ROC） curve analysis was conducted to evaluate their predictive performance for thoracolumbar fractures. Results The fracture group exhibited significantly lower mean BMD, T-scores, and HU values in L1～L4 compared to the non-fracture group, while modified VBQ scores were significantly higher （P < 0.001）. Correlation analysis revealed a significant positive correlation between BMD, T-scores, and HU values in L1～L4, whereas all three parameters showed a significant negative correlation with modified VBQ scores （P < 0.001）. The AUC values for predicting thoracolumbar fractures were 0.826 （T-score）, 0.836 （BMD）, 0.759 （HU value）, and 0.875 （modified VBQ score）, with optimal cutoff thresholds of -1.65 （T-score）, 0.836 g/cm² （BMD）, 68.4 （HU value）, and 3.01 （modified VBQ score）, respectively. Conclusion BMD, T-scores, HU values, and modified VBQ scores in L1～L4 vertebrae are significantly correlated and can serve as the predictive indicators for thoracolumbar fractures. Among them, the modified VBQ score demonstrates the best predictive performance, making it a valuable auxiliary tool for assessing the vertebral bone quality.
- Fragility fracture,
- Bone density,
- Hounsfield unit,
- Vertebral body quality score

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References(28)

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