Hsu Wei-En, Su Kuo-Chih, Chen Kun-Hui, Pan Chien-Chou, Lu Wen-Hsien, Lee Cheng-Hung
Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Appl Bionics Biomech. 2019 May 8;2019:4021640. doi: 10.1155/2019/4021640. eCollection 2019.
For compression fracture, vertebral body height loss (VBHL) and kyphotic angle (KA) are two important imaging parameters for determining the prognosis and appropriate treatment. This study used previous measurement methods to assess the degree of VBHL and KA, compare and examine differences between various measurement methods, and examine the correlation between relevant measurement parameters and intravertebral cleft (IVC) in the vertebral body. The radiographic images (lateral view of the T-L spine) of 18 patients with a single-level vertebral compression fracture were reviewed. We measured 9 characteristic lengths and angles on plain radiographs, including anterior vertebral height (AVH) and AVH of the adjacent upper and lower levels, middle vertebral height (MVH) and MVH of the adjacent upper and lower levels, posterior vertebral height (PVH), and vertebral body width, and assessed 6 parameters, including vertebral compression ratio (VBCR), percentage of anterior height compression (PAHC), percentage of middle height compression (PMHC), kyphotic angle (KA), calculated kyphotic angle (CKA), and IVC. The results showed that VBCR is a simple and rapid method of VBHL assessment, but it may result in an underestimation of the degree of VBHL compared to PAHC. When PMHC < 40% or kyphotic angle > 15°, the probability of IVC occurring on the vertebral body was higher which means the higher risk of vertebral body instability. The results of this study could provide a reference for surgeons when using imaging modalities to assess the degree of vertebral body collapse.
对于压缩性骨折，椎体高度丢失（VBHL）和后凸角（KA）是用于确定预后和合适治疗方法的两个重要影像学参数。本研究采用先前的测量方法来评估VBHL和KA的程度，比较和检验各种测量方法之间的差异，并检验椎体相关测量参数与椎体内裂隙（IVC）之间的相关性。回顾了18例单节段椎体压缩性骨折患者的放射影像（胸腰段脊柱侧位片）。我们在X线平片上测量了9个特征长度和角度，包括椎体前缘高度（AVH）及其相邻上下节段的AVH、椎体中部高度（MVH）及其相邻上下节段的MVH、椎体后缘高度（PVH）和椎体宽度，并评估了6个参数，包括椎体压缩率（VBCR）、前缘高度压缩百分比（PAHC）、中部高度压缩百分比（PMHC）、后凸角（KA）、计算后凸角（CKA）和IVC。结果表明，VBCR是评估VBHL的一种简单快速的方法，但与PAHC相比，它可能会低估VBHL的程度。当PMHC<40%或后凸角>15°时，椎体发生IVC的概率较高，这意味着椎体不稳定的风险较高。本研究结果可为外科医生使用影像学方法评估椎体塌陷程度提供参考。
