定量CT测量腰椎椎弓根螺钉钉道骨密度与椎体骨密度的对比研究  

Comparative Analysis of Cancellous Bone Mineral Density in Vertebral Bodies and Pedicle Screw Trajectories using Quantitative Computed Tomography

作　　者：于桐泊 余含笑 姚容 杨李 朱雪娥[1] Yu Tongbo;Yu Hanxiao;Yao Rong;Yang Li;Zhu Xue’e(Department of Radiology,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院放射科,江苏南京210019

出　　处：《实用骨科杂志》2024年第7期600-603,610,共5页Journal of Practical Orthopaedics

基　　金：2023年度南京市卫生科技发展专项资金项目(ZKX23064)。

摘　　要：目的利用定量CT(quantitative computed tomography,QCT)测量国人腰椎椎体与椎弓根螺钉钉道的骨密度(bone mineral density,BMD),分析两者之间是否存在差异。方法收集南京医科大学附属明基医院2021年10月至2022年4月行腰椎QCT检查的99例患者资料,男48例,女51例;年龄20~83岁,平均(50.90±15.80)岁。椎弓根螺钉钉道(G)进一步分为椎弓根内节段(R1)和椎体内节段(R2),采用QCT骨密度分析软件测量L_(2~4)椎体(R3)与椎弓根螺钉钉道的骨密度。采用单因素方差分析,比较R1、R2和R3之间骨密度的差异。采用配对样本t检验,比较R3与G之间骨密度的差异。P<0.01认为差异有统计学意义。结果椎弓根螺钉钉道BMD R1为(173.66±71.84)mg/cm^(3),R2为(113.81±48.83)mg/cm^(3),G为(143.73±55.49)mg/cm^(3),R3为(118.94±47.24)mg/cm^(3)。R1和R2之间差异有统计学意义(P<0.01),R1与R3之间差异有统计学意义(P<0.01),R2与R3之间差异无统计学意义(P>0.01)。G左侧(143.14±70.06)mg/cm^(3),G右侧(144.33±66.56)mg/cm^(3),差异无统计学意义(P>0.01);不同的腰椎节段之间BMD比较差异无统计学意义(P>0.01)。其中L_(2)为(141.25±50.32)mg/cm^(3),L_(3)为(138.31±56.85)mg/cm^(3),L 4为(151.64±58.62)mg/cm^(3)。R3平均BMD在不同腰椎节段的差异无统计学意义(P>0.01),其中L_(2)为(124.28±47.04)mg/cm^(3),L_(3)为(115.36±46.34)mg/cm^(3),L 4为(117.19±48.33)mg/cm^(3)。椎弓根螺钉钉道整体BMD高于R3,差异有统计学意义(P<0.01)。结论QCT骨密度测量技术适用于腰椎椎体及椎弓根螺钉钉道BMD的测量,椎弓根钉道BMD显著高于同节段椎体的骨密度。Objective The primary objective of this study is to assess the feasibility and accuracy of quantitative computed tomography(QCT)in analyzing the cancellous bone mineral density(BMD)of vertebral bodies and pedicle screw trajectories.Additionally,the study aims to investigate the presence and extent of any significant differences in BMD between these two anatomical regions.Methods This retrospective study was conducted under the approval of our institutional review board,with the requirement for informed consent waived due to the non-interventional nature of the analysis.From October 2021 to April 2022,data from 99 consecutive participants[48 males and 51 females,aged 20 to 80 years,with a mean age of(50.90±15.80)years]who underwent lumbar QCT examinations at The Affiliated Ben Q Hospital of Nanjing Medical University were analyzed.For each participant,the pedicle screw trajectory(designated as G)was segmented into two parts:The intrapedicular segment(R1)and the intracorporal segment(R2).Using a commercial QCT BMD analysis system,BMD measurements were obtained from the trabecular bone of lumbar vertebrae 2,3,and 4,specifically focusing on R1,R2,and the vertebral body(R3).Statistical analysis was performed using one-way ANOVA to evaluate and compare the differences in BMD among R1,R2,and R3.To further examine the difference between the BMD of the entire pedicle screw trajectory(G)and that of the vertebral body(R3),a paired t-test was conducted.A statistical significance level of P<0.01 was established for all tests employed in this study.Results The analysis revealed significant differences in BMD between the segments of the pedicle screw trajectory.Specifically,the mean BMD of the intrapedicular segment(R1)was(173.66±71.84)mg/cm^(3),which was significantly higher than that of the intracorporal segment(R2)at(113.81±48.83)mg/cm^(3)(P<0.01).Comparison of the mean BMD between R1 and the vertebral body[R3,(118.94±47.24)mg/cm^(3)]also showed a significant difference(P<0.01),whereas the difference between R2 and R3 di

关 键 词：定量CT 骨密度 椎弓根 螺钉钉道 

分 类 号：R681.5[医药卫生—骨科学]