Clinical imaging evaluation of osteoporotic spinal fracture with kyphosis by full-spine compression CT in prone position

English Keywords:Radiological examination  Cobb angle  Thoracic kyphosis  Lumbar lordosis  Osteoporosis  Kyphotic deformity

English Abstract:

  【Abstract】 Objectives： To investigate the clinical imaging significance of CT in prone position compression spine for osteoporotic spinal fracture with kyphosis. Methods: 18 cases of osteoporotic spinal fracture with kyphosis in our hospital from April 2016 to April 2017 were retrospectively analyzed, including 1 male and 17 females, aged 63.56±7.47(47-75) years old. The imaging evaluation included full length compression CT of spine in prone position and lateral standing X ray films at the preoperation, 2 weeks and final follow-up of postoperation. The local kyphosis Cobb angle(LKCA) of thoracic kyphosis, the thoracic kyphosis and lumbar lordosis were measured. The full-length CT localization images of the spine in the preoperative the prone position was compared with LK, LKCA and LL in the lateral X-ray of standing position at preoperation, 2 weeks after operation and the final follow-up. Results: LKCA, TK and LL of preoperative standing lateral radiograph were 52.46°±15.63°, 36.13°±9.55° and 33.31°±10.33°, respectively. LKCA, TK and LL of preoperative full length CT locating image in prone position were 36.94°±15.69°, 28.09°±7.62° and 26.99°±6.75°, respectively, with significant improvement compared with those in standing lateral X-ray(P<0.05). The average flexible toughness of kyphosis (31.6±7.89)%(16.4%-60.6%). At 2 weeks after operation, LKCA, TK and LL were 18.30°±3.57°, 18.23°±6.75° and 26.99°±6.75°, at the final follow-up, LKCA, TK and LL were 20.86°±5.34°, 17.92°±6.31° and 18.54°±4.77°, which had no significant difference(P>0.05). LKCA, TK and LL in 2 weeks and final follow-up and preoperative standing lateral radiograph were statistically different from those in preoperative full length CT locating image in prone position(P<0.05). Conclusions: Full-length CT localization of pressured spine in prone position is a new imaging technique. It can be used to effectively evaluate the clinical imaging of osteoporotic spinal fracture with kyphosis and thus make surgical plan.