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压缩性骨折对腰椎骨小梁评分的影响。

Effect of compression fracture on trabecular bone score at lumbar spine.

机构信息

Department of Medical Imaging, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang Dist., Tainan City, 710, Taiwan.

Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Osteoporos Int. 2021 May;32(5):961-970. doi: 10.1007/s00198-020-05707-3. Epub 2020 Oct 26.

Abstract

UNLABELLED

Bone mineral density (BMD) may be increased due to vertebral compression fractures (VCF). Our study showed trabecular bone scores (TBS) was less affected than BMD by fractured vertebrae. The TBS of most compression fractures, including old and recent VCF with mild or moderate deformity and old VCF with severe deformity, could still be used in predicting fracture risk.

INTRODUCTION

Trabecular bone score (TBS), a noninvasive tool estimating bone microarchitecture, provides complementary information to lumbar spine bone mineral density (BMD). Lumbar spine BMD might be increased due to both degenerative disease and vertebral compression fractures (VCF). Lumbar spine TBS has been confirmed not influenced by osteoarthrosis, but the effects of VCF are still not been well evaluated. This study aimed to investigate whether lumbar spine TBS was affected by fractured vertebrae.

METHODS

We studied postmenopausal women and men above 50 years old who underwent DXA between January 1, 2017, and May 31, 2019. By calculating the difference of BMD and TBS between L1 and the mean of L2-3, the study compared the difference of values between the control group and fracture group to determine the effects of fractured vertebrae on BMD and TBS.

RESULTS

A total of 377 participants were enrolled with 202 in the control group (157 females; age: 68.06 ± 6.47 years) and 175 in the fracture group (147 females; age: 71.71 ± 9.44 years). The mean BMD of the L1 vertebrae in the fracture group was significantly higher than that in the control group (p < 0.0001). There was no significant difference between the mean differences of TBS between L1 and the means of L2-3 vertebrae in the control group and the most compression fractures, including old and recent VCF with mild or moderate deformity and old VCF with severe deformity.

CONCLUSION

Lumbar spine TBS, unlike BMD, is less affected by fractured vertebrae. The TBS of most compression fractures, including old and recent VCF with mild or moderate deformity and old VCF with severe deformity, could still be used in predicting fracture risk.

摘要

目的

探讨骨密度(BMD)是否会因椎体压缩性骨折(VCF)而增加。本研究表明,与骨折椎体相比,骨小梁评分(TBS)受影响较小。大多数压缩性骨折的 TBS,包括轻度或中度畸形的新旧 VCF 和严重畸形的陈旧 VCF,仍可用于预测骨折风险。

方法

我们研究了 2017 年 1 月 1 日至 2019 年 5 月 31 日期间接受 DXA 检查的绝经后妇女和 50 岁以上的男性。通过计算 L1 与 L2-3 平均值之间 BMD 和 TBS 的差值,研究比较了对照组和骨折组之间的差值,以确定骨折椎体对 BMD 和 TBS 的影响。

结果

共纳入 377 名参与者,其中对照组 202 名(女性 157 名;年龄:68.06±6.47 岁),骨折组 175 名(女性 147 名;年龄:71.71±9.44 岁)。骨折组 L1 椎体的平均 BMD 明显高于对照组(p<0.0001)。对照组和大多数压缩性骨折(包括轻度或中度畸形的新旧 VCF 和严重畸形的陈旧 VCF)之间 L1 和 L2-3 椎体平均值之间的 TBS 平均差异无显著差异。

结论

与 BMD 不同,腰椎 TBS 受骨折椎体的影响较小。大多数压缩性骨折(包括轻度或中度畸形的新旧 VCF 和严重畸形的陈旧 VCF)的 TBS 仍可用于预测骨折风险。

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