Diagnosis of Sex Dependent Aging Effects on Cervical Vertebrae

Objectives: Bone loss due to osteoporosis is prevalently observed in and elderly people, especially, in postmenopausal women. Diagnosis of osteoporosis has used dual energy X-ray absorptiometry (DXA) by assessing bone mineral density (BMD) of a patient’s spine or hip. In a dental clinic, 3D cone beam computed tomography (CBCT) and 2D lateral cephalometric radiographs (LCR) has used to scan the whole skull of patients including cervical vertebrae. Thus, the objective of this study was to examine whether CBCT and LCR can detect age dependent changes of cervical vertebrae (C2).
Methods: After IRB approval, CBCT images taken from 152 patients (72 males and 80 females, 10 to 69 years old) were retrospectively investigated. Bone voxels are segmented from non-bone voxels and the C2 vertebral bodies were digitally isolated by removing posterior and lateral processes. Then, mean of CT attenuation values, which is proportional to BMD, was assessed. The 3D CBCT images were then converted to 2D LCR to measure C2a, which is the most infero-anterior point on the body of C2. Multivariate analysis of variance tests were performed to compare the C2a and BMD between sexes in different age groups including young (10 to 19 years), middle (20 to 49 years), old (50 to 70 years) (significant, p<0.05).
Results: The females old age group had significantly lower measures for C2a and BMD than the middle age group (p<0.04) while the male groups did not have significant age effects on the measures (p>0.05).
Conclusions: The current findings indicate that the 2D LCR based geometry measurement can provide comparable results with the 3D CBCT based BMD diagnosis to detect sex dependent aging effects.