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Research ArticleImaging

The Effect of Neck Flexion on Measurement of Spinal Bone Mineral Density and the Need to Apply Head Positioners During Dual-Energy X-Ray Absorptiometry

Mohsen Qutbi, Sajad Ghanbari, Mehdi Soltanshahi, Saba Karami Gorzi, Yaser Shiravand and Shahla Ranji
Journal of Nuclear Medicine Technology December 2020, 48 (4) 340-343; DOI: https://doi.org/10.2967/jnmt.118.216275
Mohsen Qutbi
1Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and
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Sajad Ghanbari
1Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and
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Mehdi Soltanshahi
1Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and
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Saba Karami Gorzi
2Science and Research Branch, Islamic Azad University, Tehran, Iran
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Yaser Shiravand
1Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and
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Shahla Ranji
1Department of Nuclear Medicine, Taleghani Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and
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Abstract

Our purpose was to investigate any potential effect of neck flexion on measurement of spinal bone mineral density (BMD) through further reduction of spinal lordosis and whether it is necessary to apply a head positioner, in addition to a leg positioner, during dual-energy x-ray absorptiometry. Methods: Fifty-nine patients with no significant history of spinal disorders were recruited. A bone densitometry scan of the spine was obtained for all patients using a standard leg positioner in the supine position. Then, another scan of the spine was conducted using a small subnuchal cushion to flex the neck and, thus, straighten and minimize the lumbar lordosis. Parameters including the area, bone mineral content, BMD, and T and z scores for each lumbar vertebra (L1–L4) and for the total spine were extracted from the 2 scans and compared. Results: The mean age of the patients was 55.53 y (±11.86 y); 53 (89.83%) were female and 6 (10.17%) male. A statistically significant difference was found between corresponding values for area, BMD in L4, and total spine. The percentage change from a scan without a cushion to one with a cushion was 1.20% for L4 and 0.58% for the total spine. The percentage BMD change was −0.64% for L4 and −0.34% for the total spine. A change in diagnosis—from normal to osteopenia—occurred for only 1 patient. Conclusion: Use of a head positioner to flex the neck and thus minimize lumbar lordosis in dual-energy x-ray absorptiometry does not significantly affect the diagnosis or densitometric measurements from a clinical standpoint.

  • bone mineral density
  • dual-energy x-ray absorptiometry
  • lordosis
  • head positioner

Footnotes

  • Published online Jul. 24, 2020.

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Journal of Nuclear Medicine Technology: 48 (4)
Journal of Nuclear Medicine Technology
Vol. 48, Issue 4
December 1, 2020
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The Effect of Neck Flexion on Measurement of Spinal Bone Mineral Density and the Need to Apply Head Positioners During Dual-Energy X-Ray Absorptiometry
Mohsen Qutbi, Sajad Ghanbari, Mehdi Soltanshahi, Saba Karami Gorzi, Yaser Shiravand, Shahla Ranji
Journal of Nuclear Medicine Technology Dec 2020, 48 (4) 340-343; DOI: 10.2967/jnmt.118.216275

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The Effect of Neck Flexion on Measurement of Spinal Bone Mineral Density and the Need to Apply Head Positioners During Dual-Energy X-Ray Absorptiometry
Mohsen Qutbi, Sajad Ghanbari, Mehdi Soltanshahi, Saba Karami Gorzi, Yaser Shiravand, Shahla Ranji
Journal of Nuclear Medicine Technology Dec 2020, 48 (4) 340-343; DOI: 10.2967/jnmt.118.216275
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Keywords

  • Bone mineral density
  • dual-energy x-ray absorptiometry
  • lordosis
  • head positioner
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