CT及三维重建在胸腰椎骨折患者椎弓根宽度测量研究中的应用

Application of CT and Three-dimensional Reconstruction in the Measurement of Pedicle Width in Patients with Thoracolumbar Fractures

目的探讨CT及三维重建技术在测量骨质疏松性椎体压缩骨折(osteoporosis vertebral compression fracture,OVCF)患者与中青年胸腰椎(T11~L5)骨折患者椎弓根宽度(pedicle outer width,POW)中的应用价值。方法收集2016年10月至2018年6月我院收治的所有胸腰椎骨折患者资料进行回顾性分析,其中OVCF患者105例为A组,平均年龄(73.26±6.28)岁;同期收治的创伤性胸腰椎骨折患者72例为B组,平均(38.90±8.58)岁。比较两组患者T11~L5对应椎弓根双侧POW值及不同性别间的差异,并计算POW<5mm及<7mm所占百分比。结果两组同一患者各对应脊柱左右侧POW差异无统计学意义(P>0.01),A组男性和女性T11~L3各对应POW均小于B组(P<0.01),两组患者同性别之间L4、L5比较POW差异无统计学意义(P>0.01)。A组POW小于5mm者118个,占该组总数的8.03%,主要分布于T11~L3脊椎,B组POW小于5mm者15个,占该组总数的1.49%,T12~L2均有分布;A组患者POW小于7mm占比46.87%,T11~L4均有分布,B组患者POW小于7mm患者占比13.10%,分布于T11~L3。结论对胸腰椎骨折患者术前行CT三维重建检查,有效测量椎弓根峡部宽度,能够评估手术治疗的可行性,有利于降低手术并发症发生。

Objective To investigate the application of CT and three-dimensional reconstruction technology in the measurement of pedicle outer width(POW)of osteoporotic vertebral compression fractures in patients and middle-aged and young people with thoracolumbar fractures(T11~L5).Methods Data of all patients with thoracolumbar fracture treated in our hospital from October 2016 to June 2018 were collected for retrospective analysis.Among them,105 patients with OVCF were group A,with an average age of(73.26±6.28)years old.The 72 cases of traumatic thoracolumbar fracture treated at the same time were group B,with an average of(38.90±8.58)years old.The POW values of both sides of vertebral pedicle corresponding to T11~L5 and the differences between different gendersbetween the two groupswere compared.And we calculated the patientpercentages of POW less than 5mm and 7mm.Results There was no statistical difference in POW of the left and right sides of the spine between the two groups(P>0.01).The POW corresponding of T11~L3 in groups A was smaller than that in group B(P<0.01),and no difference in L4 and L 5.There were 118 patients in group A withPOWless than 5 mm,accounting for 8.03%of the total number of the group,mainly distributed in the spine of T11~L3,and 15 patients in group B whose POW less than5mm,accounting for 1.49%.The proportion of patients with POW less than7mm in group A was 46.87%.distributedin T11~L4,and the proportion of patients with POW less than 7mm in group B was 13.10%,distributed in T11~L3.Conclusion Three-dimensional CT reconstruction examination before surgery can effectively measure the width of pedicle,evaluate the feasibility of surgical treatment,and help reduce the incidence of surgical complications.