胸腰椎压缩性骨折压缩程度评估方法比较

Study on the methods for assessment of compression extent in thoracic and lumbar vertebral compression fractures

目的探讨胸腰椎压缩性骨折压缩程度不同评估方法间的差异。方法 1.选取211例胸腰椎压缩性骨折X线片资料,用4种方法以压缩椎体前缘高度分别与其后缘、上一椎体前缘、下一椎体前缘、上下椎体前缘高度均值比较,评估相应压缩程度并比较各方法间的差异。2.选取其中146例,测量压缩椎体相邻上方三个正常椎体高度,比较中位椎体前缘高度分别与其后缘、上一椎体前缘、下一椎体前缘、上下椎体前缘高度均值的差异。结果 1.压缩椎体前缘分别与后缘、上一椎体前缘、上下椎体前缘高度均值评估的压缩程度,两两组间P<0.05;但压缩椎体前缘与后缘、下一椎体前缘评估组间P>0.05。2.正常中位椎体前缘与后缘、上一椎体前缘、下一椎体前缘高度组间均P<0.05,而与上下椎体前缘高度均值组间P>0.05,且一致性较好。结论本文不同方法对胸腰椎骨折压缩程度评估存在差异,压缩椎体前缘与上下椎体前缘高度均值比较评估其压缩程度更准确。

Objective To study and compare the different methods for assessment of compression extent in thoracic and lumbar vertebral compression fractures. Methods（ 1） From the X-ray of 211 patients with thoracic and lumbar vertebral compression fracture,four ways were used to calculated the degree of compression. The anterior vertebral body height of compressed vertebra was compared with its posterior vertebral body height,anterior height of its upper adjacent vertebra,anterior height of its lower adjacent vertebra,average of adjacent vertebra anterior height,respectively. The variability of the degree by different methods was analyzed.（ 2） The three normal upper adjacent vertebra height were measured of 146 among these patients. The anterior height of middle vertebra compared with its posterior height,anterior height of its upper / lower adjacent vertebra,average of adjacent vertebra anterior height,respectively. And the variability of height was analyzed. Results 1. There was significant variance of the compression degree by each method（ P〈0. 05）,except for the degree calculated by anterior with its posterior vertebral body height and by anterior with its lower adjacent vertebra anterior height（ P〉0. 05）. 2. The middle vertebra posterior height,the upper adjacent vertebra height,the lower adjacent vertebra height had significant variability with the middle vertebra anterior height（ P〈0. 05）. The middle vertebra anterior height had no significant variability（ P〉0. 05） but excellent correlation with average of adjacent vertebra anterior height.Conclusion In our study,there was significant variance of different ways to calculate the compression extent in thoracic and lumbar vertebral compression fractures,the compression extent calculated by compressed vertebra anterior height with average of adjacent vertebra anterior height was more accurate.