Chen Taiqiu, Hu Wenjun, Peng Yan, Li Yong, Qiu Jincheng, Qiu Xianjian, Li Pengfei, Li Shaoguang, Liang Anjing, Gao Wenjie, Huang Dongsheng
Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Orthopedics, People's Hospital of Jieyang, Jieyang, China.
Front Surg. 2022 Oct 31;9:1028873. doi: 10.3389/fsurg.2022.1028873. eCollection 2022.
Retrospective analysis.
To evaluate bone quality and investigate asymmetrical development of the thoracic vertebral body in adolescent idiopathic scoliosis (AIS) based on Hounsfield unit (HU) measurements obtained from computed-tomography (CT) scans.
HU value demonstrated higher reliability and accuracy than the traditional method, indicating that they could be used to individually evaluate and effectively assess the bone quality of every vertebra in the CT films.
Total 30 AIS patients classified as Lenke Type 1A and 30 paired controls were included in this study. Regions of interest for HU value were measured on three horizontal images of the thoracic vertebrae. HU measurements of the whole vertebral body in each vertebra were obtained. Using HU value, we separately measured the concave and convex sides of each vertebral body in patients' group, as well as within the left and right sides in controls.
In controls, the mean HU value of T1-T12 thoracic vertebral bodies was 240.03 ± 39.77, with no statistical differences among different levels. As for AIS patients, in the structural curve, the apical region had a significantly lower HU compared with the other regions, and asymmetrical change was found between the concave and convex sides, most significantly in the apical region. In the non-structural curve, the average HU value was 254.99 ± 44.48, and no significant difference was found either among the different levels of vertebrae or between the concave and convex sides.
Abnormal and asymmetrical changes in bone quality of the thoracic vertebral body in patients with Lenke 1A AIS were indicated. Low bone quality in the convex side of the structural curve indicated stronger internal fixation in surgery to correct the deformity.
回顾性分析。
基于计算机断层扫描（CT）扫描获得的亨氏单位（HU）测量值，评估青少年特发性脊柱侧凸（AIS）患者的骨质，并研究胸椎椎体的不对称发育情况。
HU值显示出比传统方法更高的可靠性和准确性，表明它们可用于单独评估和有效评估CT片上每个椎体的骨质。
本研究纳入了30例分类为Lenke 1A型的AIS患者和30例配对对照。在胸椎的三个水平图像上测量HU值的感兴趣区域。获取每个椎体整个椎体的HU测量值。利用HU值，我们分别测量了患者组中每个椎体的凹侧和凸侧，以及对照组的左侧和右侧。
在对照组中，T1 - T12胸椎椎体的平均HU值为240.03±39.77，不同节段之间无统计学差异。对于AIS患者，在结构性弯曲中，顶椎区域的HU值明显低于其他区域，且凹侧和凸侧之间存在不对称变化，在顶椎区域最为明显。在非结构性弯曲中，平均HU值为254.99±44.48，不同椎体节段之间以及凹侧和凸侧之间均未发现显著差异。
Lenke 1A AIS患者胸椎椎体骨质存在异常和不对称变化。结构性弯曲凸侧骨质质量低表明手术矫正畸形时需要更强的内固定。
