• Lin Chen, Xin-Yi Wu, Qi Jin, Guang-Yao Chen, and Xiao Ma.
• Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
• Eur Spine J. 2023 Nov 1; 32 (11): 387538843875-3884.

UnlabelledThis paper presents a comparison of quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in osteoporosis with vertebral fracture and osteoporosis without fracture. It has been proved that the volumetric bone mineral density (vBMD) measured by QCT exhibits a stronger correlation with fracture risk than areal bone mineral density (aBMD) measured by DXA.PurposeThis study aims to systematically evaluate the ability of QCT and DXA to distinguish between osteoporosis with vertebral fracture and osteoporosis without fracture according to vBMD and aBMD.MethodsWe conducted a primary literature search of the online databases up to 3 July, 2022, in both English and Chinese publications, combining synonyms for "QCT", "DXA" and "osteoporosis". The Newcastle-Ottawa scale (NOS) was employed to evaluate the quality of the selected articles. vBMD obtained through QCT and aBMD obtained through DXA were extracted, and were analyzed by Review Manager 5.4 and RStudio.ResultsSix studies with 610 individuals aged 45 to 90, of which 179 had vertebral fractures, were included in the final analysis. The weighted mean difference (WMD) between osteoporosis with vertebral fracture and osteoporosis without fracture for vBMD was - 27.08 (95% CI  - 31.24 to  - 22.92), while for aBMD was - 0.05 (95% CI - 0.08 to - 0.03).ConclusionsBoth vBMD detected by QCT and aBMD detected by DXA could discriminate fracture status in the spine, and vBMD performed a stronger correlation with fracture risk.Trial RegistrationPROSPERO 2022 CRD42022349185.© 2023. The Author(s).

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