Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, 87# Dingjiaqiao Road, Nanjing, 210009, China.
Surgery Research Center, School of Medicine, Southeast University, 87# Dingjiaqiao Road, Nanjing, 210009, China.
J Orthop Surg Res. 2023 May 27;18(1):387. doi: 10.1186/s13018-023-03874-7.
Osteoporotic vertebral compression fractures (OVCF) are common in aged population with bone fragility. This study aimed to identify the radiographic and bone fragility characteristic of acute single and multiple OVCF.
OVCF patients hospitalized in a spine center between June 2016 and October 2020 were retrospectively studied. Demographics, comorbidity, bone mineral density, spine trauma, duration of pre-hospital back pain, anatomical location and distribution pattern of OVCF, extent of vertebral marrow edema, and degree of vertebral compression of patients with multi-segment vertebral fractures (MSVF) were summarized and compared to those with single segment vertebral fractures (SSVF).
A total of 1182 patients with 1530 acute fractured vertebrae were included. There were 944 SSVF (79.9%) and 238 MSVF (20.1%) simultaneously involving two (MSVF-2) or three and more vertebra (MSVF-3/m). The Female-Male ratio was 4.4 and differed not significantly between SSVF and MSVF. Females in SSVF were younger than males while MSVF-2 tended to occur in older females. L1, T12, and L2 were the three most frequently fractured vertebra and MSVF involved more vertebra in thoracic and lumbar spine. 31.1% in MSVF-2 and 83.1% in MSVF-3/m had at least two vertebral fractures in adjacent. The fractured thoracolumbar vertebra in MSVF was less compressed than that in SSVF. Apparent spine trauma was reported by 61.4% of SSVF, 44.1% of MSVF-2, and 36.3% of MSVF-3/m, while early hospitalization with pre-hospital back pain ≤ 1 week was 58.9% in SSVF, 45.3% in MSVF-2, and 25.9% in MSVF-3/m. Only females aged 70-80 years old in MSVF-3/m showed lower baseline bone mineral density than in MSVF-2 and SSVF. MSVF were not associated with increased comorbidity of hypertension, diabetes, coronary heart disease, cerebral infarction, and chronic pulmonary disease.
20% of acute OVCF can involve multiple vertebra without significant spine trauma or lower baseline bone mineral density. Multiple OVCF tend to occur in adjacent vertebra with less thoracolumbar vertebral compression but longer duration of pre-hospital back pain.
骨质疏松性椎体压缩性骨折（OVCF）在骨骼脆弱的老年人群中很常见。本研究旨在确定急性单节段和多节段 OVCF 的影像学和骨骼脆弱特征。
回顾性研究了 2016 年 6 月至 2020 年 10 月期间在脊柱中心住院的 OVCF 患者。总结了患者的人口统计学、合并症、骨密度、脊柱外伤、院前腰痛持续时间、OVCF 的解剖位置和分布模式、椎体骨髓水肿程度以及多节段椎体骨折（MSVF）患者的椎体压缩程度，并与单节段椎体骨折（SSVF）患者进行了比较。
共纳入 1182 例 1530 例急性骨折椎体患者。其中 944 例为单节段椎体骨折（79.9%），238 例为多节段椎体骨折（20.1%），同时累及两节（MSVF-2）或三节及以上（MSVF-3/m）。女性与男性的比例为 4.4，在 SSVF 和 MSVF 之间无显著差异。SSVF 中的女性比男性年轻，而 MSVF-2 则多见于老年女性。L1、T12 和 L2 是最常发生骨折的三个椎体，MSVF 涉及更多胸腰椎体。MSVF-2 中有 31.1%，MSVF-3/m 中有 83.1%的患者至少有两个相邻椎体骨折。MSVF 中的胸腰椎骨折比 SSVF 中的压缩程度低。SSVF 中有 61.4%、MSVF-2 中有 44.1%、MSVF-3/m 中有 36.3%报告有明显的脊柱外伤，SSVF 中有 58.9%、MSVF-2 中有 45.3%、MSVF-3/m 中有 25.9%的患者在院前腰痛持续时间≤1 周内住院。只有年龄在 70-80 岁的 MSVF-3/m 女性的基线骨密度低于 MSVF-2 和 SSVF。MSVF 与高血压、糖尿病、冠心病、脑梗死和慢性肺部疾病等合并症的增加无关。
20%的急性 OVCF 可累及多个椎体，且无明显脊柱外伤或基线骨密度降低。多发性 OVCF 往往发生在相邻的椎体，胸腰椎椎体压缩程度较低，但院前腰痛持续时间较长。
