Gao Zhong-Ya, Peng Wei-Lin, Li Yang, Lu Xu-Hua
Department of Orthopaedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
World J Clin Cases. 2024 Aug 16;12(23):5329-5337. doi: 10.12998/wjcc.v12.i23.5329.
Cervical spine fracture-dislocations in patients with ankylosing spondylitis (AS) are mostly unstable and require surgery. However, osteoporosis, one of the comorbidities for AS, could lead to detrimental prognoses. There are few accurate assessments of bone mineral density in AS patients.
To analyze Hounsfield units (HUs) for assessing bone mineral density in AS patients with cervical fracture-dislocation.
The HUs from C2 to C7 of 51 patients obtained from computed tomography (CT) scans and three-dimensional reconstruction of the cervical spine were independently assessed by two trained spinal surgeons and statistically analyzed. Inter-reader reliability and agreement were assessed by interclass correlation coefficient.
The HUs decreased gradually from C2 to C7. The mean values of the left and right levels were significantly higher than those in the middle. Among the 51 patients, 25 patients (49.02%) may be diagnosed with osteoporosis, and 16 patients (31.37%) may be diagnosed with osteopenia.
The HUs obtained by cervical spine CT are feasible for assessing bone mineral density with excellent agreement in AS patients with cervical fracture-dislocation.
强直性脊柱炎（AS）患者的颈椎骨折脱位大多不稳定，需要手术治疗。然而，骨质疏松作为AS的合并症之一，可能导致不良预后。目前对AS患者骨密度的准确评估较少。
分析豪斯菲尔德单位（HUs）在评估颈椎骨折脱位AS患者骨密度中的应用。
由两名训练有素的脊柱外科医生对51例患者颈椎计算机断层扫描（CT）及三维重建图像中C2至C7椎体的HUs进行独立评估，并进行统计学分析。通过组内相关系数评估阅片者间的可靠性和一致性。
HUs从C2至C7逐渐降低。左右椎体水平的平均值显著高于中间椎体。51例患者中，25例（49.02%）可能被诊断为骨质疏松，16例（31.37%）可能被诊断为骨质减少。
颈椎CT获得的HUs可用于评估颈椎骨折脱位AS患者的骨密度，一致性良好。
