METHODS: We retrospectively enrolled patients over 50 years of age who had been subjected to surgery for fragility OVCF at China Japan Friendship Hospital from January 2021 to September 2023. Demographic characteristics, T-score based on dual-energy X-ray absorptiometry (DXA), CT-based Hounsfield unit (HU) value, vertebral bone quality (VBQ) score based on magnetic resonance imaging (MRI), relative cross-sectional area (rCSA) and the rate of fat infiltration (FI) of paraspinal muscle were collected. A 1:1 age- and sex-matched, fracture-free control group was established from patients admitted to our hospital for lumbar spinal stenosis or lumbar disk herniation.
RESULTS: A total of 78 patients with lumbar fragility OVCF were included. All the five indicators were significantly correlated with the occurrence of OVCFs. Logistic regression analysis showed that average HU value and VBQ score were significantly correlated with OVCF. The area under the curve (AUC) of VBQ score was the largest (0.89). There was a significantly positive correlation between average T-score, average HU value and average total rCSA. VBQ score was significantly positive correlated with FI.
CONCLUSIONS: VBQ score and HU value has good value in predicting of fragility OVCF. In addition to bone mineral density, we should pay more attention to bone quality, including the fatty signal intensity in bone and the FI in paraspinal muscle.
方法:我们回顾性招募了2021年1月至2023年9月在中日友好医院接受过脆性OVCF手术的50岁以上患者。人口特征,基于双能X射线吸收法(DXA)的T评分,基于CT的亨氏单位(HU)值,基于磁共振成像(MRI)的椎骨质量(VBQ)评分,收集椎旁肌的相对横截面积(rCSA)和脂肪浸润率(FI)。1:1年龄和性别匹配,无骨折对照组从我院收治的腰椎管狭窄或腰椎间盘突出症患者中设立。
结果:共纳入78例腰椎脆性OVCF患者。5项指标均与OVCFs的发生显著相关。Logistic回归分析显示,平均HU值和VBQ评分与OVCF呈显著相关。VBQ评分的曲线下面积(AUC)最大(0.89)。平均T评分之间存在显著正相关,平均HU值和平均总rCSA。VBQ评分与FI呈显著正相关。
结论:VBQ评分和HU值对脆性OVCF有较好的预测价值。除了骨密度,我们应该更加关注骨骼质量,包括骨骼中的脂肪信号强度和椎旁肌的FI。