Volume viewer椎体容积测量在胸腰椎骨折伤椎椎体内植骨中的应用

Volume Viewer Vertebral Volume Measurement in Thoracolumbar Fracture with Intravertebral Bone Grafting

目的探讨Volume viewer椎体容积测量在胸腰椎骨折伤椎椎体内植骨中的应用效果。方法收集2015—2021年收治的单节段胸腰椎骨折患者的临床资料,采用AW Siever 3.2后处理工作站Volume viewer对患者术前伤椎椎体CT扫描数据进行分析,精确计算术前伤椎椎体容积。将伤椎丢失容积<50%患者归为低丢失组,伤椎丢失容积≥50%者归为高丢失组,比较2组术后伤椎高度变化及再压缩发生率。结果共纳入70例患者,其中低丢失组37例,高丢失组33例。高丢失组患者术前伤椎容积和椎体前缘高度低于低丢失组(P<0.05)。高丢失组术后即刻及末次随访时椎体前缘高度恢复低于低丢失组(P<0.05)。高丢失组术后伤椎再压缩发生率高于低丢失组(48.5%比10.8%,P<0.05)。低丢失组中植骨患者术后再压缩发生率均与未植骨患者比较,差异无统计学意义(25.0%比9.1%,P=0.380);高丢失组中植骨患者术后再压缩发生率与未植骨患者比较差异无统计学意义(30.0%比56.5%,P=0.260)。结论术前伤椎椎体容积丢失≥50%的单节段胸腰椎骨折患者,其术后伤椎再压缩发生率高,而伤椎椎体植骨有降低术后再压缩发生率的可能。

Objective To explore the effect of volume viewer vertebral volume measurement in thoracolumbar fracture with intravertebral bone grafting.Methods The clinical data of patients with single-segment thoracolumbar fractures admitted to our hospital from January 2015 to December 2021 were retrospectively collected.The preoperative CT scan data of the fractured vertebrae of the patients were analyzed using Volume viewer,a post-processing workstation with AW Siever 3.2,to accurately calculate the preoperative vertebral volume of the fractured vertebrae.Patients with<50%volume loss of the injured vertebrae were categorized as the low loss group,and those with≥50%volume loss of the injured vertebrae were categorized as the high loss group,The postoperative height changes of the fractured vertebrae and the occurrence of re-compression were compared between the two groups.Results A total of 70 patients were included,including 37 in the low-loss group and 33 in the high-loss group.The preoperative volume of the fractured vertebra and the height of the anterior margin of the vertebral body were significantly lower in the patients in the high-loss group than in the low-loss group(P<0.05).The recovery of vertebral anterior margin height in the immediate postoperative period and at the last follow-up was lower in the high-loss group than in the low-loss group(P<0.05).The incidence of postoperative re-compression in the high-loss group was higher than that in the low-loss group(48.5%vs 10.8%,P<0.05).The incidence of postoperative re-compression was higher in patients with bone graft in the low loss group than in patients without bone graft(25.0%vs 9.1%,P=0.380);and the incidence of postoperative re-compression in patients with bone graft was lower than that in patients without bone graft in the high loss group(30.0%vs 56.5%,P=0.260),but none of the differences were statistically significant.Conclusion The incidence of postoperative re-compression in patients with single-segment thoracolumbar fracture can be high when the preoperative loss of vertebral body volume is≥50%.Bone grafting of the fractured vertebral body might have the potential to reduce the incidence of postoperative re-compression.