Queensland University of Technology Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia.
Spine (Phila Pa 1976). 2012 Apr 20;37(9):763-8. doi: 10.1097/BRS.0b013e31822ffa05.
STUDY DESIGN: A sheep study designed to compare the accuracy of static radiographs, dynamic radiographs, and computed tomographic (CT) scans for the assessment of thoracolumbar facet joint fusion as determined by micro-CT scanning. OBJECTIVE: To determine the accuracy and reliability of conventional imaging techniques in identifying the status of thoracolumbar (T13-L1) facet joint fusion in a sheep model. SUMMARY OF BACKGROUND DATA: Plain radiographs are commonly used to determine the integrity of surgical arthrodesis of the thoracolumbar spine. Many previous studies of fusion success have relied solely on postoperative assessment of plain radiographs, a technique lacking sensitivity for pseudarthrosis. CT may be a more reliable technique, but is less well characterized. METHODS: Eleven adult sheep were randomized to either attempted arthrodesis using autogenous bone graft and internal fixation (n = 3) or intentional pseudarthrosis (IP) using oxidized cellulose and internal fixation (n = 8). After 6 months, facet joint fusion was assessed by independent observers, using (1) plain static radiography alone, (2) additional dynamic radiographs, and (3) additional reconstructed spiral CT imaging. These assessments were correlated with high-resolution micro-CT imaging to predict the utility of the conventional imaging techniques in the estimation of fusion success. RESULTS: The capacity of plain radiography alone to correctly predict fusion or pseudarthrosis was 43% and was not improved using plain radiography and dynamic radiography with also a 43% accuracy. Adding assessment by reformatted CT imaging to the plain radiography techniques increased the capacity to predict fusion outcome to 86% correctly. The sensitivity, specificity, and accuracy of static radiography were 0.33, 0.55, and 0.43, respectively, those of dynamic radiography were 0.46, 0.40, and 0.43, respectively, and those of radiography plus CT were 0.88, 0.85, and 0.86, respectively. CONCLUSION: CT-based evaluation correlated most closely with high-resolution micro-CT imaging. Neither plain static nor dynamic radiographs were able to predict fusion outcome accurately.
研究设计：一项旨在比较静态射线照相、动态射线照相和计算机断层扫描（CT）扫描在评估绵羊胸腰椎小关节融合方面的准确性的研究，其结果通过微 CT 扫描确定。 研究目的：确定常规影像学技术在鉴定绵羊模型胸腰椎（T13-L1）小关节融合状态方面的准确性和可靠性。 背景资料概要：普通射线照相常用于确定胸腰椎脊柱关节融合术的完整性。许多先前的融合成功率研究仅依赖于术后普通射线照相的评估，这种技术对假关节形成的敏感性较低。CT 可能是一种更可靠的技术，但特征描述较少。 方法：11 只成年绵羊随机分为采用自体骨移植物和内固定（n = 3）或氧化纤维素和内固定（n = 8）进行尝试性融合的两组。6 个月后，由独立观察者使用（1）单独的普通静态射线照相，（2）附加的动态射线照相和（3）附加的螺旋 CT 成像进行小关节融合评估。这些评估与高分辨率微 CT 成像相关联，以预测常规成像技术在估计融合成功率方面的实用性。 结果：单独使用普通射线照相正确预测融合或假关节的能力为 43%，使用普通射线照相和动态射线照相也无法提高其准确性，其准确性为 43%。将 CT 成像评估添加到普通射线照相技术中，正确预测融合结果的能力提高到 86%。静态射线照相的灵敏度、特异性和准确性分别为 0.33、0.55 和 0.43，动态射线照相分别为 0.46、0.40 和 0.43，射线照相加 CT 分别为 0.88、0.85 和 0.86。 结论：基于 CT 的评估与高分辨率微 CT 成像相关性最密切。普通静态射线照相和动态射线照相均无法准确预测融合结果。
Zotero 插件