腰椎椎体CT值与可灌注骨水泥螺钉注入强化剂加强固定的相关性研究

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Abstract Objective To explore the relationship between vertebral CT value and whether bone cement screws need to be injected with enhancer，and preliminarily screen the critical range of CT value of vertebral body that needs bone cement reinforcement.Methods We retrospectively analyzed the data of patients who underwent lumbar internal fixation and fusion in Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine from July 2016 to June 2019.There were 89 cases and they were followed up for more than 2 years.According to whether the lumbar vertebral body was injected with bone cement，the patients were divided into bone cement group and non-bone cement group.There were 29 cases in bone cement group，with 4 cases of male and 25 cases of female.The age ranged from 54 to 84 years，with an average of (67.8±1.4) years.Non-bone cement group had 60 cases，including 20 male and 40 female.The age ranged from 52 to 85 years，with an average of (69.4±0.9) years.The Hounsfield units value of L₃，L₄and L₅vertebral bodies were measured.The correlation between Hounsfield units value and whether vertebral bodies were reinforced with bone cement was analyzed by logistic regression.The predictive value of Hounsfield units value for bone cement reinforcement was evaluated by receiver operating characteristic(ROC) curve，and the critical range of Hounsfield units value for L_3～5vertebral bodies to be reinforced with bone cement was preliminarily screened.Results The Hounsfield units value of L₃，L₄and L₅ vertebral bodies in bone cement group were (65.4±6.0) HU、(68.9±6.5)HU、(78.9±6.3)HU respectively.The CT values of L₃，L₄and L₅vertebral bodies in non-bone cement group were (97.4±3.8) HU、(101.5±4.0)HU、(117.1±5.0)HU respectively.The Hounsfield units value of L₃，L₄and L₅ vertebral bodies were significantly different between the two groups (P＜0.001).The Logistic regression results showed that the vertebral Hounsfield units value was related to whether the cement screw was filled with bone cement：L₃ vertebral body：OR=0.938，95％CI(0.909～0.967)；L₄ vertebral body：OR=0.955，95％CI(0.933～0.978)；L₅ vertebral body：OR=0.958，95％CI(0.937～0.979).There were significant negative correlation.The relationship between vertebral Hounsfield units value and ROC of lumbar pedicle screw requiring bone cement reinforcement was area under ROC curve(AUC) > 0.70 (P＜0.05).Vertebral CT value had good predictive value for bone cement reinforcement.According to the Youden index，the CT values of vertebral bodies corresponding to the maximum sum of specificity and sensitivity，that is，70HU of L₃ vertebral body，95HUof L₄ vertebral body and 99HU of L₅ vertebral body，were selected as the boundary values for predicting the need for bone cement reinforcement of vertebral bodies.Conclusion The Hounsfield units vaule of lumbar vertebral body can be used to predict whether the lumbar pedicle screw needs bone cement reinforcement fixation.The lower the CT value，the more bone cement reinforcement is recommended.

Key words： bone cement-injectable pedicle screw spinal internal fixation hounsfield units value osteoporosis screw loosening

Corresponding Authors: Yu Xing

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	Jiang Guozheng
	Feng Ningning
	Yu Xing
	Zhao He
	Qu Yi
	Wang Fengxian
	Yang Yongdong
	Ma Yukun

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Jiang Guozheng,Feng Ningning,Yu Xing, et al. Study on the Correlation Between Hounsfield Units Value of Lumbar Vertebrae and Feasibility of Enhancer Injection in Infusable Bone Cement Screw[J]. sygkzz, 2022, 28(09): 769-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I09/769

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