Abstract：
The importance of osteoporosis assessment before lumbar surgery is well recognized. The MRI-based Vertebral Bone Quality (VBQ) score is introduced to evaluate bone quality; however, its diagnostic value has not been well documented. The purpose of this meta-analysis was to summarize the diagnostic value of the VBQ score for osteoporosis or osteopenia in patients undergoing lumbar surgery. We comprehensively searched electronic databases for studies exploring the diagnostic accuracy of the VBQ score for osteoporosis/osteopenia in patients with lumbar disease following the PRISMA guidelines. The quality of the included studies was assessed. The VBQ scores were compared between the groups, and the pooled sensitivity, specificity, and summary receiver operating characteristic (ROC) were calculated. Publication bias was assessed, and meta-regression was conducted. We included 17 studies with a total of 2815 patients, with a mean age of 66.4 years and a percentage of females of 72.5%. According to the QUADAS-2 tool, the quality of the included studies was relatively high. The results showed a significantly higher VBQ score in the osteoporosis/osteopenia group compared with the control group. According to the mean VBQ cutoff value of 3.02 ± 0.38 for the diagnosis of osteoporosis, the pooled sensitivity and specificity were 0.76 and 0.74, respectively, and the AUC was 0.81. According to the mean VBQ cutoff value of 2.31 ± 0.18 for the diagnosis of osteopenia, the pooled sensitivity and specificity were 0.78 and 0.58, respectively, and the AUC was 0.76. The MRI-based VBQ score could provide useful information for identifying patients with low bone mass who need further evaluation. Future prospective studies are still needed to evaluate the complementary role of the VBQ score.
摘要：
腰椎手术前骨质疏松评估的重要性已得到公认。基于MRI的椎体骨质量（VBQ）评分被引入以评估骨质量；然而，其诊断价值尚未得到充分证明。这项荟萃分析的目的是总结VBQ评分对腰椎手术患者骨质疏松或骨量减少的诊断价值。我们全面搜索了电子数据库，以研究根据PRISMA指南，VBQ评分对腰椎疾病患者骨质疏松症/骨质减少的诊断准确性。评估纳入研究的质量。组间比较VBQ评分,和汇集的敏感性，特异性，并计算了接收器工作特性(ROC)。评估了出版偏见，并进行荟萃回归。我们纳入了17项研究，共2815名患者，平均年龄为66.4岁，女性比例为72.5%。根据QUADAS-2工具，纳入研究的质量相对较高.结果显示，与对照组相比，骨质疏松症/骨质减少组的VBQ评分明显更高。根据平均VBQ截止值3.02±0.38诊断骨质疏松,合并的敏感性和特异性分别为0.76和0.74，AUC为0.81。根据平均VBQ截断值2.31±0.18诊断骨量减少，合并的敏感性和特异性分别为0.78和0.58，AUC为0.76。基于MRI的VBQ评分可以为识别需要进一步评估的低骨量患者提供有用的信息。未来的前瞻性研究仍需评估VBQ评分的补充作用。
