Morning all,
Morning all,
I’ve just had the following results from a Dexascan of my lumbar spine. L1: −2.2, L2: −3.9, L3: −2.3. L4: −2.0
so I’ve been given a Lumbar spine score of the average which is -2.5, right on the borderline between osteopenia and osteoporosis. My question is should I question why L2 is so different? Does this pattern seem unusual? Thanks!
Hi. I think they are expecting the scores to decrease with each vertebrae. However, sometimes they can not accurately scan a vertebrae. In my case one of my vertebrae has twisted so they just leave this one out now. I found this out through MRI scan, otherwise I would have been none the wiser. Not sure in your case whether L2 is one that you have fractured and because of this is throwing out the scan. However, there are many other reasons why a DEXA does not always accurately scan, so worth researching. I went for REMS and although the hip scores were similar the spine was very different. Hope you manage to get some answers
My understanding (from the International Society for Clinical Densitometry) is that if there’s more than one standard deviation between adjacent vertebrae, the “different” vertebra should be omitted. In your case, L2 is 1.7 standard deviations from L1 and 1.6 standard deviations from L3, so L2 should be omitted. See page 7 of 2023-ISCD-Adult-Positions.pdf:
“Anatomically abnormal vertebrae may be excluded from analysis if: They are clearly abnormal and non-assessable within the resolution of the system; or There is more than a 1.0 T-score difference between the vertebra in question and adjacent vertebrae. When vertebrae are excluded, the BMD of the remaining vertebrae is used to derive the T-score.”