• Mengyang Pu, Bo Zhang, Ying Zhu, Wentao Zhong, Yixin Shen, and Peng Zhang.
• Department of Orthopedics, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing Province, Zhejiang, China; Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
• World Neurosurg. 2023 Dec 1; 180: e56e68e56-e68.

ObjectiveTo assess the consistency and accuracy of various measurements of the Hounsfield unit (HU) in lumbar vertebrae.MethodsThe study reviewed lumbar spine computed tomography images of 60 postmenopausal women aged >50 years. A total of 240 vertebrae were measured and analyzed for the variations of HU values in different sections and regions. Investigated the relationship between HU values of the lumbar spine under different measurements and dual-energy X-ray absorptiometry results and the ability to identify patients with osteoporosis.ResultsHU values measured in midsagittal (r = 0.763), midcoronal (r = 0.768), and midaxial (r = 0.786) sections exhibited a strong positive correlation with dual-energy X-ray absorptiometry T-scores. HU values measured in midsagittal and midaxial sections of the vertebral body were in good agreement (P > 0.1), but decreased in the midcoronal (P < 0.001). HU values in the middle of the vertebral body were significantly higher than in the near end plate (P < 0.001). HU values varied between L1 and L4 vertebrae, but all had a good ability to identify osteoporosis and did not differ significantly in screening ability (P > 0.05).ConclusionsAn averaged HU value in axial multilevel is a comprehensive assessment of vertebral bone density. Using the HU value of the lumbar spine can help identify patients with osteoporosis, and the screening ability does not differ significantly across vertebral segments.Copyright © 2023 Elsevier Inc. All rights reserved.

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