Anderst William J, West Tyler, Donaldson William F, Lee Joon Y
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, USA.
Orthopaedic Research Laboratories, 3820 South Water Street, Pittsburgh, PA, 15203, USA.
Eur Spine J. 2017 Sep;26(9):2281-2289. doi: 10.1007/s00586-017-5119-2. Epub 2017 May 6.
Bone mineral density (BMD) measured using quantitative computed tomography (QCT) has been shown to correlate with bone mechanical properties. Knowledge of BMD within specific anatomic regions of the spine is valuable to surgeons who must secure instrumentation to the vertebrae, to medical device developers who design screws and disc replacements, and to researchers who assign mechanical properties to computational models. The objective of this study was to comprehensively characterize BMD in the cervical spine of young healthy adults.
QCT was used to determine BMD in the cervical spines of 31 healthy adults (age 20-35). Subject-specific 3D models of each vertebra were created from CT scans, and anatomic regions of interest were identified in each bone (C1: 3 regions; C2: 9 regions, C3-C7: 13 regions). Statistical tests were performed to identify differences in BMD according to vertebral level, anatomic regions within vertebrae, and sex.
BMD varied significantly among vertebral levels and among anatomic regions within each vertebra. Females had higher BMD than males (p = .041) primarily due to higher BMD in the posterior regions of each vertebra.
These data can serve as a baseline to identify BMD changes in older and symptomatic patients. This data set is also the first report of volumetric bone density within different anatomic regions of the atlas and axis of the cervical spine. The finding of higher BMD in females is in agreement with the previous QCT results but contradicts DEXA results that are known to be dependent upon bone size.
使用定量计算机断层扫描(QCT)测量的骨矿物质密度(BMD)已被证明与骨力学性能相关。了解脊柱特定解剖区域内的骨密度对于必须将器械固定到椎骨上的外科医生、设计螺钉和椎间盘置换物的医疗器械开发商以及为计算模型赋予力学性能的研究人员来说非常有价值。本研究的目的是全面表征年轻健康成年人颈椎的骨密度。
使用QCT测定31名健康成年人(年龄20 - 35岁)颈椎的骨密度。从CT扫描创建每个椎体的个体特异性三维模型,并在每块骨中确定感兴趣的解剖区域(C1:3个区域;C2:9个区域,C3 - C7:13个区域)。进行统计测试以确定根据椎体水平、椎体内解剖区域和性别的骨密度差异。
骨密度在椎体水平之间以及每个椎体内的解剖区域之间存在显著差异。女性的骨密度高于男性(p = 0.041),主要是因为每个椎体后部区域的骨密度较高。
这些数据可作为识别老年和有症状患者骨密度变化的基线。该数据集也是颈椎寰椎和枢椎不同解剖区域内体积骨密度的首次报告。女性骨密度较高的发现与先前的QCT结果一致,但与已知依赖于骨大小的DEXA结果相矛盾。