Shao Hu, Yang Lianda, Hu Hanfeng, Qian Ying, Zhang Linlin, Yang Huilin
Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188#, Shizi Road, Suzhou, 215006, China.
Department of Radiology, The First Affiliated Hospital of Soochow University, 188#, Shizi Road, Suzhou, 215006, China.
Sci Rep. 2025 May 28;15(1):18665. doi: 10.1038/s41598-025-01739-z.
This study was to investigate vertebral body bone mineral density (BMD) changes using a novel automatic phantom-less quantitative CT (PL-QCT) system in short and relatively long-term periods after posterior open reduction and internal fixation. 109 patients (77 men [70.6%]; median age, 48 [IQR 37, 55]) who underwent posterior open reduction and internal fixation for thoracolumbar fractures were enrolled into the study. The median follow-up duration was 441 days (IQR 377-553). Based on the median follow-up time, patients were divided into Group 1 (378 days [IQR 350-412]) and Group 2 (553 days [IQR 493-706]). Bone mineral density (BMD) was measured for the injured vertebrae, the upper and lowest instrumented vertebra, as well as the cranial and caudal adjacent vertebrae preoperatively and postoperatively. The postoperative BMD in all segments was significantly lower compared to the preoperative values (P < 0.05). There was no difference in BMD loss between Group1 and Group2 (P > 0.05). The BMD loss in the anterior region of the caudal adjacent vertebra was greater than that in the posterior region (- 13.0 mg/cm³ [IQR - 26.8, - 6.8] vs. - 12.0 mg/cm³ [IQR - 20.8, - 3.1], P = 0.006). Early monitoring and intervention for bone loss following surgery, particularly focusing on the anterior region of the adjacent vertebrae, could potentially aid in improving clinical outcomes with more follow-up studies.
本研究旨在使用一种新型的自动无体模定量CT（PL-QCT）系统，调查后路切开复位内固定术后短期和相对长期内椎体骨密度（BMD）的变化。109例接受胸腰椎骨折后路切开复位内固定术的患者（77例男性[70.6%]；中位年龄48岁[四分位间距37,55]）纳入本研究。中位随访时间为441天（四分位间距377 - 553）。根据中位随访时间，患者被分为第1组（378天[四分位间距350 - 412]）和第2组（553天[四分位间距493 - 706]）。术前和术后测量损伤椎体、最上和最下固定椎体以及头侧和尾侧相邻椎体的骨密度（BMD）。所有节段术后的BMD均显著低于术前值（P < 0.05）。第1组和第2组之间的BMD丢失无差异（P > 0.05）。尾侧相邻椎体前部的BMD丢失大于后部（-13.0mg/cm³[四分位间距-26.8,-6.8] vs. -12.0mg/cm³[四分位间距-20.8,-3.1]，P = 0.006）。术后对骨质流失进行早期监测和干预，特别是关注相邻椎体的前部，可能有助于通过更多的随访研究改善临床结果。
