Centre of Excellence "TeleOrto" for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, Warsaw, Poland; Department of Orthopaedics and Traumatology of the Locomotor System, Baby Jesus Clinical Hospital, Warsaw, Poland.
Centre of Excellence "TeleOrto" for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, Warsaw, Poland; Chair and Department of Orthopaedics and Traumatology of the Locomotor System, Medical University of Warsaw, Warsaw Poland.
J Clin Densitom. 2019 Jul-Sep;22(3):367-373. doi: 10.1016/j.jocd.2018.11.003. Epub 2018 Nov 9.
To evaluate the relationship between cortical Bone Mineral Density (BMD) at pedicle entry points with trabecular BMD of the vertebral body in a spinal fracture.
Quantitative computed tomography of the thoracolumbar spine was analyzed using dedicated software - QCT Pro (Mindways, Austin, TX).
Forty-six patients were evaluated. Among them 36 females were diagnosed with osteoporosis; the remaining 10 randomly selected from the database both males and females served as a control group. Overall measurements for 138 vertebrae were assessed. Cortical BMD of entry points for transpedicular screws was higher than trabecular vertebral BMD in osteoporotic (p < 0.001) and non-osteoporotic patients (p = 0.003). The difference was 3.6 times higher in low BMD cases (osteoporosis), compared to 2.3 times in normal subjects. Spearman's rank correlation coefficient showed the strongest correlation between patient's age and trabecular bone mineral density of L1 vertebral body (r = -0.94, p < 0.05), while cortical entry points were less correlated (r = -0.8, p < 0.05 and r = -0.65, p < 0.05 for left and right entry points, respectively). The strength of the correlations between BMD and age decreased gradually from L1 to L4, from r = -0.94 to r = -0.58 for the trabecular vertebral body; from r = -0.8 to r = -0.37 for entry points. Significant correlations were not found for BMD and the height or weight of the patients.
Cortical BMD at pedicle entry points decreases with osteoporosis. The relative contribution of cortical vs trabecular BMD increases with osteoporosis. Vertebral trabecular BMD is highly correlated with the cortical BMD of the entry points and allows predicting the bone support in fracture cases.
评估脊柱骨折患者椎弓根入点皮质骨骨密度（BMD）与椎体松质骨 BMD 之间的关系。
使用专用软件-QCT Pro（Mindways，Austin，TX）对胸腰椎定量计算机断层扫描进行分析。
共评估了 46 名患者。其中 36 名女性被诊断为骨质疏松症；数据库中随机选择的另外 10 名男女患者作为对照组。共评估了 138 个椎体的整体测量值。骨质疏松症和非骨质疏松症患者的椎弓根螺钉入点皮质 BMD 均高于松质骨 BMD（p<0.001 和 p=0.003）。低 BMD 病例（骨质疏松症）的差异是正常人群的 3.6 倍，而正常人群的差异是 2.3 倍。Spearman 秩相关系数显示，患者年龄与 L1 椎体松质骨骨密度之间存在最强相关性（r=-0.94，p<0.05），而皮质入点相关性较小（r=-0.8，p<0.05 和 r=-0.65，p<0.05 分别为左侧和右侧入点）。BMD 与年龄之间的相关性强度从 L1 到 L4 逐渐减弱，从 r=-0.94 到 r=-0.58 对于松质骨椎体；从 r=-0.8 到 r=-0.37 对于入点。未发现 BMD 与患者身高或体重之间存在显著相关性。
椎弓根入点皮质骨 BMD 随骨质疏松症而降低。皮质骨 BMD 与松质骨 BMD 的相对贡献随骨质疏松症而增加。椎体松质骨 BMD 与入点皮质骨 BMD 高度相关，可预测骨折病例中的骨支撑。
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