• Yao Gao, Guofu Zhang, Xiaomei Tian, and Minguang Zhang.
• Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Yangtze River Delta Integration Demonstration Zone (QingPu), Shanghai, 201713, P.R. China.
• World Neurosurg. 2025 Jan 24: 123712123712.

IntroductionDegenerative lumbar scoliosis (DLS) often causes various issues such as neural symptoms and osteoporosis (OP). Vertebral bone quality (VBQ) is a crucial factor that surgeons take into consider prior to surgery. However, little attention has been given to the use of VBQ in evaluating vertebral bone mass in DLS patients. The aim of this study was to investigate the ability of MRI-based VBQ score to evaluate bone mass in patients with DLS and its ability to predict OP.MethodsA total of 130 patients were enrolled and divided into the DLS and non-DLS groups. The VBQ scores of the L1-L4 vertebral bodies were measured in noncontrast T1WI. Dual X-ray absorptiometry (DXA) was used to assess osteoporotic status. Additionally, patients with DLS were divided into two groups: with vertebral rotatory subluxation (VRS) and without VRS. The VBQ scores, CT values, and DXA indicators were compared between the DLS and non-DLS groups, and between VRS and non-VRS groups. VBQ was compared with the CT value, bone density and T-score using the Pearson correlation coefficient. VBQ was obtained according to the non-DLS group and compared with the accuracy of diagnosing osteoporosis with DXA.ResultsThe DLS group was significantly different from the non-DLS group in terms of the VBQ score (3.53 vs. 2.98), CT value (109.81 vs. 134.60), T score (-1.19 vs. -1.72) and bone mineral density (BMD) value (1.04 vs. 0.94). The VRS group presented a larger Cobb angle, lower CT value and higher VBQ score. The AUC of the VBQ score in the prediction of osteoporosis was 0.804, with a sensitivity of 68.4% and a specificity of 85.7%.ConclusionVBQ can reduce interference from degeneration and deformities and can be used as a complementary method for vertebral quality assessment.Copyright © 2025. Published by Elsevier Inc.

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