排除骨折或异常椎骨对小梁骨评分测量的影响。
Effect of excluding fractured or abnormal vertebrae on the trabecular bone score measurement.
作者信息
Lin Yen-Huai, Teng Michael Mu Huo
机构信息
Department of Medical Imaging, Cheng Hsin General Hospital, 45 Cheng Hsin Street, Taipei, 112, Taiwan.
Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
出版信息
Arch Osteoporos. 2024 Dec 27;20(1):4. doi: 10.1007/s11657-024-01485-1.
UNLABELLED
Brief rationale: The use of L1-L4 vertebrae, without exclusions, has been recommended for trabecular bone score (TBS) measurements.
MAIN RESULT
Excluding abnormal and fractured vertebrae affected the TBS. Significance of the paper: Fracture or degenerative abnormality may not affect TBS. The preferred action may involve including all levels without exclusions.
PURPOSE
The use of L1-L4 vertebrae, without exclusions, has been recommended for trabecular bone score (TBS) measurements. We aimed to investigate the effect of excluding fractured or abnormal vertebrae from TBS.
METHODS
Dual-energy X-ray absorptiometry images of 2767 participants, including 1080 without excluded vertebrae, 556 with fractured vertebrae, and 1131 with abnormal vertebrae showing a 1.0 T-score difference compared to the adjacent vertebrae, were retrospectively reviewed. Differences between TBS measurements with and without fractured or abnormal vertebrae were evaluated.
RESULTS
Among 1080 participants without excluded vertebrae, TBS was 1.234 at L1, 1.296 at L2, 1.308 at L3, and 1.301 at L4. A significantly higher mean TBS was seen after excluding L1, whereas a significantly lower mean TBS was seen after excluding L2-L4. In the 556 participants with fractured vertebrae, excluding the involved level from the TBS calculation led to a significant difference in the total sample, women, ≥ 70 years old, and overweight subgroups. A significantly higher mean TBS was seen after excluding the fractured L1, whereas a significantly lower mean TBS was seen after excluding fractures at L2-L4. Among the 1131 participants with abnormal vertebrae, excluding the involved level from the TBS led to a significant difference in age, sex, and body mass index subgroups. Excluding abnormal L1 and L4 vertebrae led to a significantly higher and lower mean TBS, respectively.
CONCLUSION
Excluding fractured or abnormal vertebrae led to differences in TBS across various subgroups. Regarding the effect of vertebral level exclusion, the observed differences may be attributed to the systematic intervertebral variation, which is unrelated to any effect from fractures or degenerative abnormalities.
未标注
简要理论依据：推荐使用L1 - L4椎体进行小梁骨评分（TBS）测量，无排除标准。
主要结果
排除异常和骨折椎体影响TBS。论文意义：骨折或退行性异常可能不影响TBS。首选做法可能是无排除标准地纳入所有椎体水平。
目的
推荐使用L1 - L4椎体进行小梁骨评分（TBS）测量，无排除标准。我们旨在研究从TBS中排除骨折或异常椎体的影响。
方法
回顾性分析2767名参与者的双能X线吸收测定图像，其中1080名无排除椎体，556名有骨折椎体，1131名有与相邻椎体相比T值相差1.0的异常椎体。评估有或无骨折或异常椎体时TBS测量值的差异。
结果
在1080名无排除椎体的参与者中，L1椎体的TBS为1.234，L2为1.296，L3为1.308，L4为1.301。排除L1后平均TBS显著升高，而排除L2 - L4后平均TBS显著降低。在556名有骨折椎体的参与者中，从TBS计算中排除受累椎体水平导致总样本以及女性、≥70岁和超重亚组出现显著差异。排除骨折的L1后平均TBS显著升高，而排除L2 - L4骨折后平均TBS显著降低。在1131名有异常椎体的参与者中，从TBS中排除受累椎体水平导致年龄、性别和体重指数亚组出现显著差异。排除异常的L1和L4椎体分别导致平均TBS显著升高和降低。
结论
排除骨折或异常椎体导致各亚组TBS存在差异。关于椎体水平排除的影响，观察到的差异可能归因于系统性的椎间变异，这与骨折或退行性异常的任何影响无关。
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