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Abstract：
To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI).
One hundred and five thoracolumbar fracture (T11-L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (A/P ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV). T test, Pearson\'s Chi-square and multivariate logistic regression were calculated for the variables.
Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm, P = 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°, P = 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°, P = 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (P = 0.004 and P < 0.001, respectively), increased AED (P = 0.010), LK >25° (P = 0.024), AVH (P < 0.001), and BFOFV (P < 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408, P = 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494, P = 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (P = 0.035 and 0.001, respectively) or SSL rupture (P = 0.014 and 0.008, respectively).
Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI, A/P ratio, and AVH ratio are not.
One hundred and five thoracolumbar fracture (T11-L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (A/P ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV). T test, Pearson\'s Chi-square and multivariate logistic regression were calculated for the variables.
Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm, P = 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°, P = 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°, P = 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (P = 0.004 and P < 0.001, respectively), increased AED (P = 0.010), LK >25° (P = 0.024), AVH (P < 0.001), and BFOFV (P < 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408, P = 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494, P = 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (P = 0.035 and 0.001, respectively) or SSL rupture (P = 0.014 and 0.008, respectively).
Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI, A/P ratio, and AVH ratio are not.
摘要：
探讨放射学参数是否与磁共振成像（MRI）识别的后韧带复合体（PLC）损伤密切相关。
本研究回顾性分析了105例胸腰椎骨折（T11-L2）患者。根据MRI上PLC的状态将患者分为不同的组：完整，不完全破裂和破裂。影像学参数包括前边缘-下终板角度（AEIEA），前缘位移（AED），Cobb角（CA），区域角度(RA)，矢状指数（SI），局部后凸(LK),前/后椎体高度比（A/P比），椎体前高度比（AVH比），和骨折椎骨（BFOFV）前面的骨碎片。T试验,计算变量的Pearson卡方和多变量逻辑回归。
肌腱上韧带（SSL）断裂与完整的关系不仅与AEIEA<70°的发生有关，LK>25°和BFOFV，而且随着AED的增加（9.89±3.12mm和9.34±3.36mm，P=0.034),RA(9.52±3.93°对7.91±3.99°,P=0.042),和LK（23.98±5.88°与15.55±5.28°，P=0.021)。棘突间韧带（ISL）损伤的适应症包括AEIEA<75°，AEIEA<70°（分别为P=0.004和P<0.001），AED增加（P=0.010），LK>25°(P=0.024),AVH（P<0.001），和BFOFV（P<0.001）。多因素logistic回归分析显示，AEIEA<70°和BFOFV是SSL破裂[标准偏回归系数（beta）分别为0.439和0.408，P=0.003和0.001]和ISL破裂（beta分别为0.548和0.494，P=0.028和0.001）的高危因素。增加的AED和LK>25°也与ISL破裂（分别为P=0.035和0.001）或SSL破裂（分别为P=0.014和0.008）有关。
我们的数据可能在基于普通射线照相成像的PLC完整性的初步评估中被证明是有用的。我们显示放射学适应症，如AEIEA<70°，BFOFV,LK>25°,并增加AED，与ISL或SSL破裂相关，而RA,CA,SI,A/P比率，和AVH比率不是。
本研究回顾性分析了105例胸腰椎骨折（T11-L2）患者。根据MRI上PLC的状态将患者分为不同的组：完整，不完全破裂和破裂。影像学参数包括前边缘-下终板角度（AEIEA），前缘位移（AED），Cobb角（CA），区域角度(RA)，矢状指数（SI），局部后凸(LK),前/后椎体高度比（A/P比），椎体前高度比（AVH比），和骨折椎骨（BFOFV）前面的骨碎片。T试验,计算变量的Pearson卡方和多变量逻辑回归。
肌腱上韧带（SSL）断裂与完整的关系不仅与AEIEA<70°的发生有关，LK>25°和BFOFV，而且随着AED的增加（9.89±3.12mm和9.34±3.36mm，P=0.034),RA(9.52±3.93°对7.91±3.99°,P=0.042),和LK（23.98±5.88°与15.55±5.28°，P=0.021)。棘突间韧带（ISL）损伤的适应症包括AEIEA<75°，AEIEA<70°（分别为P=0.004和P<0.001），AED增加（P=0.010），LK>25°(P=0.024),AVH（P<0.001），和BFOFV（P<0.001）。多因素logistic回归分析显示，AEIEA<70°和BFOFV是SSL破裂[标准偏回归系数（beta）分别为0.439和0.408，P=0.003和0.001]和ISL破裂（beta分别为0.548和0.494，P=0.028和0.001）的高危因素。增加的AED和LK>25°也与ISL破裂（分别为P=0.035和0.001）或SSL破裂（分别为P=0.014和0.008）有关。
我们的数据可能在基于普通射线照相成像的PLC完整性的初步评估中被证明是有用的。我们显示放射学适应症，如AEIEA<70°，BFOFV,LK>25°,并增加AED，与ISL或SSL破裂相关，而RA,CA,SI,A/P比率，和AVH比率不是。
