Applicability of dynamic X-ray in early identification and prognosis prediction of osteoporotic vertebral fractures

ZHANG Peng; KANG Lixing; DUAN Yujia; MA Haoqing

doi:10.3969/j.issn.2097-1753.2025.05.013

Abstract：Objective To explore the applicability of dynamic X-ray in early identification and prognosis prediction of vertebral osteoporotic fractures.Methods A total of 100 patients with vertebral osteoporotic fractures who were treated surgically at Langfang People's Hospital from June 2019 to June 2022 were selected and randomly divided into a control group and an observation group,each consisting of 50 cases.Both groups were diagnosed with vertebral osteoporotic fractures via anteroposterior and lateral X-ray imaging and underwent minimally invasive surgery,specifically percutaneous vertebroplasty or percutaneous kyphoplasty.The control group received only anteroposterior and lateral X-ray examinations before surgery while the observation group received dynamic imaging guidance during the procedure.The spinal angle,scores of Visual Analogue Scale(VAS),and vertebral function scores of the two groups were evaluated to assess the therapeutic effect.Results All patients had their fractures confirmed through X-ray examination.The imaging signs varied among patients,primarily characterized by calcification,gas accumulation,and vacuum fractures.Vacuum fractures amounted to severe fractures,while calcification features indicated mild fractures.In all fracture patients,the bone spongy level around the lesion was found to be elevated.After surgery,the comparison of sagittal parameters between the two groups showed no statistically significant differences in the T1 pelvic angle and lumbar lordosis angle(both P＞0.05).However,the observation group had significantly better results in the vertical axis,sacral angle,and thoracic kyphosis angle than the control group(t=2.061,2.310,2.242,P=0.042,0.023,0.027).The results of repeated measures analysis showed that the VAS scores and vertebral function scores in the observation group compared favorably with the control group at 4 and 8 weeks after surgery(P＜0.001,＜0.001,=0.012,＜0.001).The results of Logistic regressionanalyse indicated that three factors were indentified as influencing factors:the vertical axis(OR=0.200,95％CI=0.052-0.771),sacral angle(OR=0.097,95％CI=0.024-0.391)and thoratic kyphosis angle(OR=0.855,95％CI=0.754-0.970).Conclusion Dynamic X-ray can facilitate early identification and prognosis prediction of vertebral osteoporotic fractures.