{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:42:28Z","timestamp":1790203348264,"version":"4.1.0"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate the predictive performance of a simplified, MRI-derived vertebral bone quality score (VBQ) using measurements at L1\/2 (VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      ) for opportunistic bone quality screening, compared to the established VBQ\n                      <jats:sub>L1-4.<\/jats:sub>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In patients undergoing lumbar surgery for degenerative spondylolisthesis, VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      was assessed using circular regions of interest on sagittal T1-weighted sequences in L1 and L2, while VBQ\n                      <jats:sub>L1-4<\/jats:sub>\n                      included measurements from L1 through L4. Measurements were normalized to cerebrospinal fluid intensity at L2\/3. Bone mineral density (BMD) was measured by opportunistic qCT, with osteoporosis defined as BMD &lt; 80\u00a0mg\/cm\n                      <jats:sup>3<\/jats:sup>\n                      and impaired bone quality (osteoporosis or osteopenia) as BMD &lt; 120\u00a0mg\/cm\n                      <jats:sup>3<\/jats:sup>\n                      . Agreement between VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      and VBQ\n                      <jats:sub>L1-4<\/jats:sub>\n                      was determined using the intraclass correlation coefficient (ICC), and predictive performance was evaluated using receiver operating characteristic analysis with Youden\u2019s index optimization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 144 patients included ((39% male,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 56) the median age was 69\u00a0years (interquartile range 64-67). Osteopenia was present in 47% and osteoporosis in 22%, yielding 69% impaired bone quality. VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      and VBQ\n                      <jats:sub>L1-4<\/jats:sub>\n                      showed excellent agreement (ICC: 0.988, 95% CI: 0.982\u20130.991). Predictive performance was comparable for osteoporosis (AUC: VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      0.71 vs. VBQ\n                      <jats:sub>L1-4<\/jats:sub>\n                      0.69) and impaired bone quality (AUC: 0.68 vs. 0.67). For osteoporosis detection, VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      showed a higher sensitivity (94% vs 71%) but a lower specificity (45% vs 64%), as well as for detecting impaired bone quality (sensitivity 77% vs. 47%, 56%, vs 82%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      VBQ\n                      <jats:sub>L1\/2<\/jats:sub>\n                      offers a simplified alternative to VBQ\n                      <jats:sub>L1-4<\/jats:sub>\n                      for MRI-based bone quality assessment. Further validation and threshold refinement are warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261462059","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T18:56:47Z","timestamp":1782241007000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Streamlining the MRI-Derived Vertebral Bone Quality Score for Preoperative Osteoporosis and Osteopenia Screening"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7473-6553","authenticated-orcid":false,"given":"Paul","family":"K\u00f6hli","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 \u2013 University Medical Center Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"BIH Charit\u00e9 Junior Clinician Scientist Program, BIH Biomedical Innovation Academy, Berlin Institute of Health at Charit\u00e9 - University Medical Center Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7663-9043","authenticated-orcid":false,"given":"Ali E.","family":"Guven","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Maria","family":"Mielke","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 \u2013 University Medical Center Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Alschuler","sequence":"additional","affiliation":[{"name":"Center for Biostatistics, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranqing","family":"Lan","sequence":"additional","affiliation":[{"name":"Center for Biostatistics, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hambrecht","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9646-2397","authenticated-orcid":false,"given":"Erika","family":"Chiapparelli","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0743-8860","authenticated-orcid":false,"given":"Lukas","family":"Sch\u00f6nnagel","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 \u2013 University Medical Center Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5185-4482","authenticated-orcid":false,"given":"Gisberto","family":"Evangelisti","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Duculan","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Shue","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koki","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Hospital for Special 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