Nakamae Toshio, Kamei Naosuke, Fujimoto Yoshinori, Yamada Kiyotaka, Ujigo Satoshi, Adachi Nobuo
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
Spine Surg Relat Res. 2021 Jun 30;6(2):139-144. doi: 10.22603/ssrr.2021-0066. eCollection 2022.
The purpose of this study was to assess radiological features and clinical scores of osteoporotic vertebral fracture (OVF) accompanied by spinous process fracture (SPF).
We included painful patients with single-level OVF with intravertebral cleft. SPF was detected using magnetic resonance imaging (MRI) and/or computed tomography (CT). The plain radiographs of the vertebral fractures were evaluated based on the wedging angle of the fractured vertebrae and vertebral instability. We investigated the clinical parameters of age, gender, visual analog scale (VAS) score for low back pain (LBP), Oswestry Disability Index (ODI), and the period from the onset of acute fracture.
MRI and/or CT indicated among 195 patients of OVF with LBP, 41 patients (20.5%) had SPFs. SPFs were observed one level above the fractured vertebral body in 35 patients (85.4%) and at the same level as the fractured vertebral body in 6 patients (14.6%). The prevalence of vertebral fracture of thoracic spine in the SPF-positive group was significantly greater than that in the SPF-negative group. There were no significant differences in age, gender, VAS, ODI, the time period from the onset of acute LBP, wedging angle, and vertebral instability between the presence or absence of SPFs.
SPFs occurred in 20.5% of patients with OVF and LBP. In addition, SPFs often occurred one level above the fractured vertebra, and SPFs with OVF tended to be located in the thoracic spine.
本研究旨在评估伴有棘突骨折（SPF）的骨质疏松性椎体骨折（OVF）的影像学特征和临床评分。
我们纳入了患有单节段伴有椎体内裂隙的OVF且有疼痛症状的患者。通过磁共振成像（MRI）和/或计算机断层扫描（CT）检测SPF。基于骨折椎体的楔形变角度和椎体不稳定情况对椎体骨折的X线平片进行评估。我们调查了年龄、性别、下腰痛（LBP）的视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）以及急性骨折发病后的时间等临床参数。
MRI和/或CT显示，在195例患有LBP的OVF患者中，41例（20.5%）有SPF。35例（85.4%）患者的SPF位于骨折椎体上方一个节段，6例（14.6%）患者的SPF与骨折椎体处于同一节段。SPF阳性组胸椎椎体骨折的患病率显著高于SPF阴性组。有无SPF在年龄、性别、VAS、ODI、急性LBP发病后的时间、楔形变角度和椎体不稳定方面无显著差异。
在伴有LBP的OVF患者中，20.5%发生了SPF。此外，SPF常发生在骨折椎体上方一个节段，且伴有OVF的SPF往往位于胸椎。
