Study on Bone Quality Analysis of Lumbar Fusion Surgery in Patients with Osteoporosis Based on MRI Vertebral Bone Quality Score and CT Bone Microstructures
Objective This study aims to evaluate the bone quality of lumbar fusion surgery in patients with osteoporosis based on MRI vertebral body bone quality score and CT bone microstructure analysis,in order to provide reference for clinical diagnosis and treatment.Methods Quantitative computed tomography(QCT)measurements were performed on the lumbar spine,and patients with vBMD≤120 mg/cm3 were classified as osteopenia/osteoporosis using L1/L2 mean values.Using sagittal T1 weighted magnetic resonance imaging,the average signal intensity of the L1 L4 vertebral body was divided by the signal intensity of the cerebrospinal fluid to obtain the VBQ score.Bone biopsy taken from the posterior superior iliac spine during surgery and evaluated using MCT.Compare the VBQ scores and MCT parameters between the normal group and the bone loss/osteoporosis group.Spearman correlation(R)was used to analyze the correlation between VBQ score,MCT parameters,and vBMD.ROC analysis identified VBQ score as a predictive factor for bone loss/osteoporosis.Multiple linear regression analysis with vBMD L1/L2 as the result was used to identify independent predictors from VBQ,MCT parameters and Demographics.Results Osteopenia/osteoporosis prevalence in 267 patients It was 65.2 per cent.VBQ score and vBMD score(r=-0.300;P＜0.01),bone trabecula BV/TV(r=-0.314;P＜0.01),Tb.N(r=-0.326;P＜0.01)had a significant negative correlation,and a positive correlation with Tb.Sp(r=0.349;P＜0.01).The accuracy of VBQ score in predicting the prognosis of osteopenia/osteoporosis showed an AUC value of 0.670.Multiple linear regression analysis showed that age(b=-0.400;P=0.003),bone trabecular volume fraction(bv/tv)(b=0.420;P=0.012)and trabecular thickness(Tb.Th)(b=-0.234;P=0.048)predictable volumetric bone density.Conclusion The VBQ score is related to the bone trabecular microstructure determined by MCT,and there is a significant difference between the bone microstructure and VBQ score in patients with VBMD damage.However,the ability to predict bone loss/osteoporosis using the VBQ score is moderate.The VBQ score reflects additional bone quality characteristics and may have a complementary effect on vBMD.
Bone MicrostructureReduced Bone MassSpinal FusionVolume Bone Density
万方数据
维普
