老年腰椎压缩性骨折行胸椎MRI检查的必要性研究

Necessity of thoracic magnetic resonance imaging in elderly patients with lumbar compression fractures

目的研究老年腰椎压缩性骨折患者进行胸椎MRI检查的必要性。方法选取自2018-01—2023-03于苏州大学附属第二医院采用经皮穿刺椎体成形术(Percutaneous vertebroplasty,PVP)或经皮椎体后凸成形术(Percutanous kyphoplasty,PKP)治疗的1504例腰椎骨折。术前均进行了胸腰椎X线、CT及MRI检查。根据患者年龄,以10年为年龄段进行整理统计,分析每个年龄段腰椎骨折患者同时合并胸椎新发骨折的数量和比例。同时统计各节段腰椎骨折合并胸椎新发骨折的数量和比例,以及常见合并胸椎新发骨折的位置、数量和比例。结果共纳入1504例(笔者所在医院腰椎MRI检查可以包含T_(11)~L_(5)椎体),女1158例,男346例;年龄(73.42±4.38)岁。有196例(13.03%)合并胸椎新发骨折。以10年为一个年龄段进行整理统计,51~>90岁患者中各年龄段的胸椎新发骨折检出率均≥10%。分别对T_(11)至L_(5)各骨折节段进行分析,除T_(12)、L_(1)及L_(2)椎体外,其余所有节段合并胸椎新发骨折比率均≥10%。合并胸椎新发骨折好发部位排名前三的是T_(10)(55椎,24.66%)、T_(9)(49椎,21.97%)和T_(8)(47椎,21.08%)。结论老年腰椎压缩性骨折患者可能会同时合并胸椎骨折,因此有必要对这类患者同时进行胸椎MRI检查,以评估整体脊柱情况。

Objective To evaluate the necessity of additional thoracic magnetic resonance imaging(MRI)in elderly patients with lumbar compression fractures.Methods One thousand and five hundred and four cases of lumbar fractures treated with percutaneous vertebroplasty(PVP)or percutaneous kyphoplasty(PKP)from January 2018 to March 2023 at the Second Affiliated Hospital of Suzhou University were included.Thoracic and lumbar X-ray,CT,and MRI examinations were performed before surgery.According to the patient's age,statistics were conducted in the 10-year age groups.The number and proportion of patients with lumbar fractures in each age group who combined with new thoracic fractures were analyzed.Simultaneously,the number and proportion of new thoracic fractures combined with lumbar fractures in each segment were recorded as well as the location,quantity,and proportion of new common thoracic fractures.Results A total of 1504 cases(the lumbar MRI examination at the author's hospital could cover T_(11)-L_(5) vertebrae)were included,with 1158 females and 346 males,age(73.42±4.38)years old.There were 196 cases(13.03%)with new thoracic fractures.According to statistics conducted on the 10-year age groups,the detection rate of new thoracic fractures in patients aged 51 to over 90 is≥10%for each age group.Analysis was conducted on each fracture segment from T_(11)to L_(5).And except for T_(12),L_(1) and L_(2),the incidence of new thoracic fractures in all other segments was≥10%.The top three most common sites for new thoracic fractures are T_(10)(55 vertebrae,24.66%),T_(9)(49 vertebrae,21.97%),and T_(8)(47 vertebrae,21.08%).Conclusion Elderly patients with lumbar compression fractures may combine with thoracic fractures at the same time,so it is necessary to carry out additional thoracic magnetic resonance examination for such patients to assess the overall spinal condition.