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Good bone quality is key in avoiding a multitude of afflictions, including osteoporotic fragility fractures and poor outcomes after spine surgery. In patients undergoing instrumented spine fusion, bone quality often dictates screw pullout strength, insertional torque, and vertebral body loading properties. While dual-energy X-ray absorptiometry (DEXA) screening is the current method of assessing bone mineral density, the majority of patients do not have DEXA measurements available before undergoing surgical instrumentation.

To create a simple magnetic resonance imaging (MRI)-based score to evaluate bone quality and evaluate the degree to which it correlates with conventional DEXA scores.

Retrospective cohort.

Patients ≥18 years of age undergoing spine surgery for degenerative conditions between 2013 and 2018.

Correlation of the …