Abstract:Objective To investigate the application of CT and three-dimensional reconstruction technology in the measurement of pedicle outer width (POW) of osteoporotic vertebral compression fractures in patients and middleaged and young people with thoracolumbar fractures(T11~L5).Methods Data of all patients with thoracolumbar fracture treated in our hospital from October 2016 to June 2018 were collected for retrospective analysis.Among them,105 patients with OVCF were group A,with an average age of (73.26±6.28)years old.The 72 cases of traumatic thoracolumbar fracture treated at the same time were group B,with an average of (38.90±8.58)years old.The POW values of both sides of vertebral pedicle corresponding to T11~L5 and the differences between different gendersbetween the two groupswere compared.And we calculated the patientpercentages of POW less than 5mm and 7mm.Results There was no statistical difference in POW of the left and right sides of the spine between the two groups (P>0.01).The POW corresponding of T11~L3 in groups A was smaller than that in group B (P<0.01),and no difference in L4 and L5.There were 118 patients in group A withPOWless than 5 mm,accounting for 8.03% of the total number of the group,mainly distributed in the spine of T11~L3,and 15 patients in group B whose POW less than5mm,accounting for 1.49%.The proportion of patients with POW less than7mm in group A was 46.87%.distributedin T11~L4,and the proportion of patients with POW less than 7mm in group B was 13.10%,distributed in T11~L3.Conclusion Three-dimensional CT reconstruction examination before surgery can effectively measure the width of pedicle,evaluate the feasibility of surgical treatment,and help reduce the incidence of surgical complications.
刘旭 1,张进 2. CT及三维重建在胸腰椎骨折患者椎弓根宽度测量研究中的应用[J]. 实用骨科杂志, 2019, 25(7): 607-615.
Liu Xu 1,Zhang Jin 2. Application of CT and Three-dimensional Reconstruction in the Measurement of Pedicle Width in Patients with Thoracolumbar Fractures. sygkzz, 2019, 25(7): 607-615.
[1]Svedbom A,Hernlund E,Ivergard M,et al.Osteoporosis in the european union:a compendium of countryspecific reports[J].Archives of Osteoporosis,2013,8(1-2):137-139.
[2]Takahara K,Kamimura M,Moriya H,et al.Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women[J].BMC Musculoskeletal Disorders,2016(17):12-16.
[3]Alexandru D,So W.Evaluation and management of vertebral compression fractures[J].Perm J,2012,16(4):46-51.
[4]Kanis JA.Diagnosis of osteoporosis and assessment of fracture risk[J].Lancet,2002,359(9321):1929-1936.
[5]Borensztein M,Camino Willhuber GO,Posadas Martinez ML,et al.Analysis of risk factors for new vertebral fracture after percutaneous vertebroplasty[J].Global Spine J,2018,8(5):446-452.
[6]Jung HJ,Park YS,Seo HY,et al.Quality of life in patients with osteoporotic vertebral compression fractures[J].J Bone Metab,2017,24(3):187-196.
[7]Munusamy T,Thien A,Anthony MG,et al.Computed tomographic morphometric analysis of cervical pedicles in a multiethnic Asian population and relevance to subaxial cervical pedicle screw fixation[J].Eur Spine J,2015,24(1):120-126.
[8]Patwardhan AR,Nemade PS,Bhosale SK,et al.Computed tomography-based morphometric analysis of cervical pedicles in Indian population:a pilot study to assess feasibility of transpedicular screw fixation[J].J Postgrad Med,2012,58(2):119-122.
[9]Makino T,Kaito T,Fujiwara H,et al.Analysis of lumbar pedicle morphology in degenerative spines using multiplanar reconstruction computed tomography:what can be the reliable index for optimal pedicle screw diameter? [J].Eur Spine J,2012,21(8):1516-1521.
[10]Liang C,Sun J,Cui X,et al.Spinal sagittal imbalance in patients with lumbar disc herniation:its spinopelvic characteristics,strength changes of the spinal musculature and natural history after lumbar discectomy[J].BMC Musculoskeletal Disorders,2016(17):305.
[11]Imagama S,Matsuyama Y,Hasegawa Y,et al.Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males[J].European Spine Journal,2011,20(6):954-961.
[12]Dai J,Yu X,Huang S,et al.Relationship between sagittal spinal alignment and the incidence of vertebral fracture in menopausal women with osteoporosis:a multicenter longitudinal followup study[J].Eur Spine J,2015,24(4):737-743.
[13]Galibert P,Deramond H,Rosat P,et al.Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty [J].Neurochirurgie.1987(33):166-168.