基于椎体松质骨CT值评估下骨质疏松状态与椎板倾斜角度相关性的研究

A study on the correlation between osteoporosis status and laminar slope angle based on assessment of CT values of vertebral cancellous bone

目的研究基于椎体松质骨CT值评估下骨质疏松状态与椎板倾斜角度的相关性。方法200例同时行腰椎CT和X线检查的患者,按年龄分为中老年组(n=100,>50岁)和青壮年组(n=100,≤50岁)。两组患者均进行腰4椎体松质骨CT值测量和腰4椎板倾斜角测量。对比两组患者腰4椎板倾斜角度与腰4椎体松质骨CT值;分析200例患者CT值与椎板倾斜角度的关系;对比两组患者的腰椎滑脱发生率。结果中老年组患者的腰4椎板倾斜角度(116.03±11.88)°大于青壮年组的(107.93±10.54)°(P<0.05);中老年组患者的腰4椎体松质骨CT值(73.25±8.38)Hu低于青壮年组的(178.21±13.99)Hu(P<0.05)。折线图分析显示:CT值在75~125 Hu区间时,为缓冲区间;当CT值<75 Hu时,倾斜角度增大趋势明显升高。中老年组患者的腰椎滑脱发生率33.00%高于青壮年组的1.00%(P<0.05)。结论随着年龄的增长,腰4椎体松质骨CT值会降低,腰4椎板倾斜角度会变大,腰椎滑脱发生率增加,故可通过椎体松质骨CT值对骨质疏松状态进行评估。腰4椎体CT值在75~125 Hu时,就要积极抗骨质疏松防止椎板变形;当CT值<75 Hu时,椎板变形倾斜角增大趋势明显升高,进而加大腰椎滑脱风险。

Objective To study the correlation between osteoporosis status and laminar slope angle based on assessment of CT values of vertebral cancellous bone.Methods 200 patients who underwent both lumbar CT and X-ray examinations were divided into a middle-aged and elderly group(n=100,>50 years old)and a young and middle-aged group(n=100,≤50 years old)according to age.Both groups of cases were subjected to CT measurement of the vertebral cancellous bone of the lumbar 4 vertebra and measurement of the laminar slope angle of the lumbar 4 vertebra,and the two sets of data were compared.The correlation between CT values and vertebral plate inclination angle in 200 patients was analyzed.The incidence of lumbar spondylolisthesis was compared between two groups of patients.Results The laminar slope angle of the lumbar 4 vertebra was(116.03±11.88)°in the middle-aged and elderly group,which was higher than(107.93±10.54)°in the young and middle-aged group(P<0.05).The CT value of the vertebral cancellous bone of the lumbar 4 vertebra was(73.25±8.38)Hu in the middle-aged and elderly group,which was lower than(178.21±13.99)Hu in the young and middleaged group(P<0.05).Line chart analysis showed that the CT value was buffered when it was in the range of 75 to 125 Hu;when the CT value was<75 Hu,the tendency of increasing the tilt angle was significantly higher.The incidence of lumbar spondylolisthesis in the middle-aged and elderly group of patients was 33.00%,which was higher than 1.00%in the young and middle-aged group(P<0.05).Conclusion With increasing age,the CT value of the vertebral cancellous bone of the lumbar 4 vertebra decreases,the laminar slope angle of the lumbar 4 vertebra increases,and the incidence of lumbar spondylolisthesis rises.Therefore,the evaluation of osteoporotic status can be conducted through the CT values of the vertebral cancellous bone.When the CT values of the lumbar 4 vertebra are within the range of 75 to 125 Hu,proactive measures should be taken to counteract osteoporosis and prevent vertebral plate deformation;when the CT value is below 75 Hu,there is a noticeable increase in the trend of greater slope angle in vertebral plate deformation,subsequently elevating the risk of lumbar spondylolisthesis.