Department of Spine Surgery, Sixth Affiliated Hospital of Xinjiang Medical University, 39, Wuxing Nan Rd, Tianshan District, Urumqi, Xinjiang 86830001, China.
Department of Orthopaedics, Sixth Affiliated Hospital of Xinjiang Medical University, 39 Wuxing Nan Rd, Tianshan District, Urumqi, Xinjiang 86830001, China.
Biomed Res Int. 2022 May 23;2022:7123139. doi: 10.1155/2022/7123139. eCollection 2022.
To find a preoperative computed tomography-based method to predict the incidence of sacral screw loosening and assist surgical planning.
Surgically treated patients for degenerative lumbosacral disorders with rigid pedicle screw fixation of patients with L5-S1 vertebra in our center from January 2016 to January 2021 were retrospectively included in the current study. CT scan attenuation of the horizontal plane of the sacrum was measured with Hounsfield units (HU). Postoperative X-ray tests were used to diagnose screw loosening. The data was analyzed by independent sample -tests, analysis, Pearson correlation analysis, and ROC curve analysis.
A total of 162 (114 male, 48 female, average age 63.7 ± 7.3 years) patients were included in the final analysis. Significant differences were found between the screw loosening group and nonloosening group concerning the HU value of the sacrum at the horizontal plane ( < 0.01). In ROC curve analysis, AUC was 0.674 (95% CI: 0.592-0.756). A cutoff of 200 HU provided 64.8% sensitivity and 62.4% specificity, and a cutoff of 150 HU provided 90.2% sensitivity.
Analyzing 162 patients with at least 12 months of follow-up, we propose cutoff CT attenuation values of 200 HU and 150 HU to take moderate and radical measures of screw augmentation to prevent screw loosening in the sacral bone.
寻找一种基于术前计算机断层扫描的方法来预测骶骨螺钉松动的发生率，并协助手术规划。
回顾性纳入 2016 年 1 月至 2021 年 1 月在我院接受治疗的退行性腰骶疾病患者，这些患者接受了 L5-S1 椎骨刚性椎弓根螺钉固定。用 Hounsfield 单位（HU）测量骶骨水平面的 CT 扫描衰减值。术后 X 射线检查用于诊断螺钉松动。使用独立样本 t 检验、卡方检验、Pearson 相关分析和 ROC 曲线分析对数据进行分析。
共有 162 名患者（114 名男性，48 名女性，平均年龄 63.7 ± 7.3 岁）最终纳入分析。螺钉松动组与非松动组之间，骶骨水平 HU 值存在显著差异（<0.01）。在 ROC 曲线分析中，AUC 为 0.674（95%CI：0.592-0.756）。当截断值为 200 HU 时，灵敏度为 64.8%，特异性为 62.4%；当截断值为 150 HU 时，灵敏度为 90.2%。
通过对至少 12 个月随访的 162 名患者进行分析，我们提出了 200 HU 和 150 HU 的 CT 衰减值截断值，以便采取中度和激进的螺钉增强措施来预防骶骨螺钉松动。
