{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:19:50Z","timestamp":1787015990096,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Dual energy x\u2010ray absorptiometry (DXA) provides incomplete information about bone strength. There are few data on the relationship between osteoporosis\u2010related examinations and bone strength. The objective of the present study was to determine which osteoporosis\u2010related examinations best predicted trabecular bone strength, and to enhance a formula for predicting bone strength on the basis of bone density examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study included postmenopausal women (aged over 50\u2009years) who underwent unilateral percutaneous kyphoplasty (PKP) surgery in the lumbar spine between September 2021 and June 2023. The pressure within each balloon expansion circle was extracted to reflect the true bone strength. The NHANES 2013\u20132014 data were used to assess the performance of the formula. The performance of the formula was compared with that of the observed actual fractures. Bland\u2013Altman analysis was used to compare the agreement between the formula and the fracture risk assessment tool (FRAX) score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 40 postmenopausal women (mean age\u2009\u00b1\u2009standard deviation, 70.90\u2009years \u00b1\u200910.30) were enrolled. The average balloon pressure was 59.23\u2009psi (\u00b1\u200912.40, means \u00b1 SDs). The mean BMD of total lumbar spine (average of L1\u2013L4) was 0.89\u2009g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      \u2009\u00b1\u20090.20 (mean\u2009\u00b1\u2009standard), and the Pearson correlation coefficient between lumbar BMD and bone strength was 0.516. After adjusting for age and BMI, the DXA response rate to bone strength reached 72%. Calibration plots of the observed actual fractures versus those estimated via the bone strength formula were considered good fits. The Bland\u2013Altman analysis revealed a nonsignificant difference between the formula and the FRAX score in predicting fracture risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After adjustment, the DXA response rate to bone strength reached 72%, indicating a strong correlation. In addition, Bone Strength\u2009=\u2009DXA \u00d7 27 \u2212 Age \u00d7 0.585\u2010BMI \u00d7 0.887\u2009+\u200998.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.14354","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T03:50:56Z","timestamp":1736394656000},"page":"1067-1074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["How Accurately Does Bone Mineral Density Predict Bone Strength? A Clinical Observational Study of Osteoporosis Vertebral Compression Fractures in Postmenopausal Women"],"prefix":"10.1111","volume":"17","author":[{"given":"Xuemeng","family":"Mu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3802-5997","authenticated-orcid":false,"given":"Jia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing 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