Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary`s Hospital, Incheon, Republic of Korea.
Catholic Kwandong University of Korea College of Medicine, Gangneung, Republic of Korea.
Medicine (Baltimore). 2023 Sep 15;102(37):e35173. doi: 10.1097/MD.0000000000035173.
The relationship between vertebral body cross-sectional area (VBCSA) and spinal conditions associated with increased lumbar lordosis, such as lumbar spondylolysis (LSL), is not known. We investigated the morphological parameter, VBCSA, to predict LSL. The VBCSA on MRI has not been studied for its association with LSL. We hypothesized that VBCSA is an important morphological parameter for LSL prediction. We collected VBCSA data from 90 patients (43 males and 47 females) with LSL and 91 control subjects (44 males and 47 females) who underwent lumbar spine magnetic resonance imaging (LS-MRI). Axial T2-weighted LS-MRI images were obtained from all participants. Using our picture archiving and communications system, we analyzed the VBCSA at the level of the L5 vertebral body by utilizing MRI. The average VBCSA was 2263.51 ± 306.02 mm2 in the male control group and 1820.92 ± 224.89 mm2 in the male LSL group. LSL patients had significantly lower VBCSAs (P < .001) than did the male controls. The average VBCSA was 1985.21 ± 258.05 mm2 in the female control group and 1553.73 ± 250.02 mm2 in the female LSL group, and the LSL patients also had significantly lower VBCSAs (P < .001) than did the female controls. The optimal VBCSA cutoff value in the male group was 2014.69 mm2 with 76.7% sensitivity, 75.0% specificity, and an area under the receiver operating curve (AUC) of 0.89 (95% CI: 0.82-0.95). In the female group, the optimal cutoff score was 1814.11 mm2 with 76.6% sensitivity, 76.6% specificity, and an AUC of 0.88 (95% CI: 0.82-0.95). VBCSA is a sensitive objective morphological parameter for assessing LSL, and a lower VBCSA is associated with a higher possibility of LSL. We believe that these results will be useful in diagnostic radiology for evaluating patients with LSL.
椎体横截面积（VBCSA）与增加腰椎前凸相关的脊柱状况（如腰椎峡部裂，LSL）之间的关系尚不清楚。我们研究了形态参数 VBCSA，以预测 LSL。MRI 上的 VBCSA 尚未研究其与 LSL 的关系。我们假设 VBCSA 是预测 LSL 的重要形态学参数。我们收集了 90 例 LSL 患者（43 名男性和 47 名女性）和 91 例对照组（44 名男性和 47 名女性）的 VBCSA 数据，这些患者均接受了腰椎磁共振成像（LS-MRI）检查。所有参与者均接受轴向 T2 加权 LS-MRI 图像检查。使用我们的图片存档和通信系统，通过 MRI 分析 L5 椎体水平的 VBCSA。男性对照组的平均 VBCSA 为 2263.51±306.02mm2，男性 LSL 组的平均 VBCSA 为 1820.92±224.89mm2。LSL 患者的 VBCSA 明显低于男性对照组（P<0.001）。女性对照组的平均 VBCSA 为 1985.21±258.05mm2，女性 LSL 组的平均 VBCSA 为 1553.73±250.02mm2，LSL 患者的 VBCSA 也明显低于女性对照组（P<0.001）。男性组的最佳 VBCSA 截断值为 2014.69mm2，敏感性为 76.7%，特异性为 75.0%，接受者操作特征曲线（AUC）下面积为 0.89（95%CI：0.82-0.95）。在女性组中，最佳截断值为 1814.11mm2，敏感性为 76.6%，特异性为 76.6%，AUC 为 0.88（95%CI：0.82-0.95）。VBCSA 是评估 LSL 的敏感客观形态学参数，较低的 VBCSA 与较高的 LSL 可能性相关。我们相信这些结果将有助于诊断放射学评估 LSL 患者。
