老年骨质疏松性椎体压缩骨折和中青年胸腰椎骨折患者椎弓根宽度的CT观察

The CT measurement of pedicle width in young-middle aged and elder patients with thoracolumbar vertebral fracture

中文关键词:  骨质疏松性椎体压缩骨折  胸腰椎  椎弓根宽度  骨密度

英文关键词:Osteoporotic vertebral compression fracture  Thoracolumbar spine  Pedicle width  Bone mineral density

中文摘要:

  【摘要】 目的：观察胸腰椎（T11-L5）骨质疏松性椎体骨折（osteoporotic vertebral fracture，OVF）和中青年椎体骨折患者椎弓根宽度及变化特点。方法：将2012年6月~2015年1月我院收治OVF患者152例作A组，年龄60~95岁平均72.5±7.0岁，BMD-2.5～-5.4SD,平均-3.5±0.65SD；同期收治创伤性胸腰椎骨折患者192例作为B组，年龄26~50岁,平均33.5±4.6岁，BMD未测。均采用CT薄层扫描多平面重建（MPR）技术测量T11~L5各对应脊椎椎弓根宽度（pedicle outer width，POW）。观察两组患者各对应脊椎POW及两组男女性别间各对应脊椎POW差异。两组各对应脊椎POW＜5mm及＜7mm的百分比。结果：两组男性T11~L3各对应脊椎POW大于女性（P＜0.01）。A组男性T11~L3各对应脊椎POW均小于B组男性（P＜0.01），A组女性T11~L3各对应脊椎POW均小于B组女性（P＜0.01）。无论组别及性别L4、L5脊椎POW无显著性差异（P＞0.05）。POW<5mm的百分比：A组占该组椎弓根测量数的11%，分布于T11～L3，其中男性占椎弓根测量数5%，女性占椎弓根测量数13%；B组占椎弓根测量总数的7%，分布于T12～L2，其中男性占椎弓根测量数5%，B组女性占椎弓根测量数11%。POW<7mm百分比：A组占所测椎弓根总数的53%，分布于T11～L4，其中男性占椎弓根测量数39%，女性占57%；B组占椎弓根测量数的14%，分布于T11～L3，其中男性占该组椎弓根测量数12%，女性占该组椎弓根测量数19%。结论：在胸腰椎尤其是T11-L3部位，老年OVF组椎弓根宽度明显小于中青年组，女性的椎弓根宽度比男性更小。

英文摘要:

  【Abstract】 Objectives: To observe the width and characteristics of pediclein patients with osteoporotic vertebral fracture(OVF) and younger patients with traumatic vertebral fracture(TVF). Methods: 152 patients diagnosed as OVF enrolled in our hospital from June 2012 to January 2015 were assigned in group A, the average age was 72.5±5.5 years(range, 60 to 95), the mean BMD was -3.5±0.65SD(range, -2.5 to -5.4); 192 patients diagnosed as TVF were assigned in group B at the same period, the average age was 33.5±4.6 years, the BMD of the group was not tested. The thin slice computer tomography scan and multiple planar reconstruction(MPR) were applied to measure the pedicle outer width(POW) from T11 to L5, the POW less than 5mm and less than 7mm and intersexual features were compared between two groups. Results: The POW of male patients was larger than that of female patients from T11 to L3 in both groups; POW of male patients in group A was significantly smaller than that of group B from T11 to L3; POW of female patients in group A was significantly smaller than group B from T11 to L3. There was no difference of POW at L4 and L5 in two groups, and intersexual difference was not found. Patients with POW less than 5mm accounted for 11% of the total pedicles from T11 to L3 in group A. Male patients with POW less than 5mm accounted for 5% and female patients accounted for 13% of the total pedicles in group A. Patients with POW less than 5mm accounted for 7% of the total pedicles from T12 to L2 in group A. Male patients with POW less than 5mm accounted for 5% and female patients accounted for 11% of the total pedicles in group B. POW less than 7mm in group A accounted for 53% of the total pedicles, these distributed from T11 to L4. Male patients with POW less than 7mm accounted for 39% of the pedicles, female patients accounted for 57%. POW less than 7mm in group A accounted for 14%, these distributed from T11 to L3. Male patients with POW less than 7mm accounted for 12% and female patients accounted for 19%. Conclusions: The width of pedicle in group A is significantly smaller than that in group B in thoracolumbar spine, especially from T11 to L3, female has smaller pedicle width than male.