Wang Yunsheng, Dong Mei, Zhang Jiali, Miao Dechao, Wang Feng, Tong Tong, Wang Linfeng
Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.
Key Laboratory of Orthopedic Biomechanics of Hebei Province, Shijiazhuang, China.
Neurospine. 2024 Sep;21(3):966-972. doi: 10.14245/ns.2448310.155. Epub 2024 Sep 30.
To investigate the ability of radiological parameter canal bone ratio (CBR) to assess bone mineral density and to differentiate between patients with primary and multiple osteoporotic vertebral compression fracture (OVCF).
A retrospective analysis was conducted on OVCF patients treated at our hospital. CBR was measured through full-spine x-rays. Patients were categorized into primary and multiple fracture groups. Receiver operating characteristic curve analysis and area under the curve (AUC) calculation were used to assess the ability of parameters to predict osteoporosis and multiple fractures. Predictors of T values were analyzed by multiple linear regression, and independent risk factors for multiple fractures were determined by multiple logistic regression analysis.
CBR showed a moderate negative correlation with dual-energy x-ray absorptiometry T values (r = -0.642, p < 0.01). Higher CBR (odds ratio [OR], -6.483; 95% confidence interval [CI], -8.234 to -4.732; p < 0.01) and lower body mass index (OR, 0.054; 95% CI, 0.023-0.086; p < 0.01) were independent risk factors for osteoporosis. Patients with multiple fractures had lower T values (mean ± standard deviation [SD]: -3.76 ± 0.73 vs. -2.83 ± 0.75, p < 0.01) and higher CBR (mean ± SD: 0.54 ± 0.07 vs. 0.46 ± 0.06, p < 0.01). CBR had an AUC of 0.819 in predicting multiple fractures with a threshold of 0.53. T values prediction had an AUC of 0.816 with a threshold of -3.45. CBR > 0.53 was an independent risk factor for multiple fractures (OR, 14.66; 95% CI, 4.97-43.22; p < 0.01).
CBR is negatively correlated with bone mineral density (BMD) and can be a novel opportunistic BMD assessment method. It is a simple and effective measurement index for predicting multiple fractures, with predictive performance not inferior to T values.
探讨影像学参数椎管骨比率（CBR）评估骨密度以及区分原发性和多发性骨质疏松性椎体压缩骨折（OVCF）患者的能力。
对我院治疗的OVCF患者进行回顾性分析。通过全脊柱X线测量CBR。将患者分为原发性骨折组和多发性骨折组。采用受试者工作特征曲线分析和曲线下面积（AUC）计算来评估各参数预测骨质疏松症和多发性骨折的能力。通过多元线性回归分析T值的预测因素，并通过多元逻辑回归分析确定多发性骨折的独立危险因素。
CBR与双能X线吸收法T值呈中度负相关（r = -0.642，p < 0.01）。较高的CBR（比值比[OR]，-6.483；95%置信区间[CI]，-8.234至-4.732；p < 0.01）和较低的体重指数（OR，0.054；95%CI，0.023 - 0.086；p < 0.01）是骨质疏松症的独立危险因素。多发性骨折患者的T值较低（平均值±标准差[SD]：-3.76±0.73 vs. -2.83±0.75，p < 0.01），CBR较高（平均值±SD：0.54±0.07 vs. 0.46±0.06，p < 0.01）。CBR在预测多发性骨折时的AUC为0.819，阈值为0.53。T值预测的AUC为0.816，阈值为-3.45。CBR > 0.
