Yamauchi Taro, Sharma Sagar, Chandra Sarath, Tanaka Masato, Fujiwara Yoshihiro, Arataki Shinya, Sharma Ayush, Yokoyama Yusuke, Oomori Toshinori, Kanamaru Akihiro, Masuda Shin, Shimizu Noriyuki, Torigoe Kenta, Honda Osamu
Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan.
Department of Orthopedic Surgery, Smt. N.H.L. Municipal Medical College, Pritan Rai Cross Road, Ellise Bridge, Paldi, Ahmedabad 380006, India.
J Clin Med. 2022 Aug 24;11(17):4968. doi: 10.3390/jcm11174968.
Retrospective observational study.
Sacral insufficiency fractures (SIF) are relatively rare fractures and difficult to diagnose on plain radiographs. The primary objective of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) for the diagnosis of SIF. The secondary objective was to identify the classification of SIF by computed tomography (CT).
A total of 77 (Male 11, female 66, mean 80.3 years) people were included in this study. Inclusion criteria for this study were: age ≥ 60 years and no history of high energy trauma. Exclusion criteria were high energy trauma and a current history of malignancy. Differences in the fracture detection and description in the various radiologic procedures were evaluated. Fracture patterns were evaluated with CT. The detection rates of additional pathologies in the MRI of the pelvis and lumbar spine were also recorded.
The sensitivities for SIF were 28.5% in radiographs and 94.2% in CT, and all fractures were detected in MRI. MRI showed a more complex fracture pattern compared with CT in 65% of the cases. We observed 71.4% of single SIFs, 9.1% with other spinal fractures, 13.0% with other pelvic fractures, and 7.8% with other fractures. According to the SIF fracture pattern, the H/U type was 40.2%, transverse type was 33.7%, λ/T type was 24.7%, unilateral vertical type was 1.3%, and bilateral vertical type was 0%.
an MRI of the lumbar spine including the sacrum with a coronal fat-suppressed T2-weighted image is useful for elderly patients with suddenly increasing low back pain at an early stage. This procedure improves an early SIF detection, recognition of concomitant pathologies, and adequate treatment for the patients.
回顾性观察研究。
骶骨不全骨折（SIF）是相对罕见的骨折，在普通X线片上难以诊断。本研究的主要目的是评估腰椎磁共振成像（MRI）在SIF诊断中的作用。次要目的是通过计算机断层扫描（CT）确定SIF的分类。
本研究共纳入77例患者（男性11例，女性66例，平均年龄80.3岁）。本研究的纳入标准为：年龄≥60岁且无高能创伤史。排除标准为高能创伤和当前恶性肿瘤病史。评估了各种放射学检查中骨折检测和描述的差异。用CT评估骨折类型。还记录了骨盆和腰椎MRI中其他病变的检出率。
X线片对SIF的敏感性为28.5%，CT为94.2%，MRI能检测到所有骨折。65%的病例中，MRI显示的骨折类型比CT更复杂。我们观察到71.4%为单一SIF，9.1%合并其他脊柱骨折，13.0%合并其他骨盆骨折，7.8%合并其他骨折。根据SIF骨折类型，H/U型占40.2%，横型占33.7%，λ/T型占24.7%，单侧垂直型占1.3%，双侧垂直型占0%。
对伴有骶骨的腰椎进行MRI检查，包括冠状位脂肪抑制T2加权成像，对早期突然出现下腰痛的老年患者有用。该检查可提高SIF的早期检测率，识别合并病变，并为患者提供适当治疗。
