Efficacy of Quantitative CT Bone Imaging Parameters and Bone Mineral Density in Predicting Secondary Fractures in Patients with Thoracolumbar Fractures after PVP
YANG Haiqing
LI Haibo
ZHANG Rui
ZHAO Jianhui
ZHANG Zhijian
Abstract：Objective To investigate the efficacy of quantitative CT bone imaging parameters and bone mineral densi-ty(BMD)in predicting secondary fractures in thoracolumbar fracture patients after percutaneous vertebroplasty(PVP).Methods A total of 135 patients with thoracolumbar fracture treated from January 2020 to December 2022 were selected and divided into the secondary group(n=27)and the non-secondary group(n=108)according to whether there was secondary vertebral refracture at 1 year after surgery.Baseline data,preoperative quantitative CT bone imaging parameters and BMD were compared between the two groups,and the predictive efficacy of each parameter and BMD on secondary fractures after PVP was analyzed.Results The age of the secondary group was higher than that of the non-secondary group,and the inci-dence of bone cement leakage was higher than that of the non-secondary group(P＜0.05).CT bone imaging parameters in the secondary group were higher than those in the non-secondary group,while BMD was lower than that in the non-secondary group(P＜0.01).Vertebral compression rate,vertebral wedge angle,local kyphotic angle,increased spinous process dis-tance,and increased pedicle distance were negatively correlated with BMD(r=-0.688,-0.463,-0.519,-0.481,-0.504,P＜0.001).The area under the receiver operating characteristic(AUC)curve(AUC)of vertebral compression ra-tio,vertebral wedge angle,local kyphotic angle,increased spinous process distance,increased pedicle distance and BMD for predicting secondary fractures after PVP in patients with thoracolumbar fracture was 0.761,0.833,0.808,0.847,0.814 and 0.782,respectively.The risk of secondary fracture after PVP was 5.445,15.164,5.105,7.722,and 8.800 times higher in thoracolumbar fracture patients with high level of vertebral compression rate,vertebral wedge angle,local kyphotic angle,in-creased spinous process distance,and increased pedicular distance than in patients with low level.The risk of secondary frac-ture after PVP in patients with low BMD was 6.214 times higher than that in patients with high BMD.The AUC of combined quantitative CT bone imaging parameters and BMD for predicting secondary fracture AUC after PVP in patients with thoraco-lumbar fracture was greater than that predicted by each parameter and BMD alone,with a sensitivity of 92.59%and a speci-ficity of 76.85%.Conclusion Quantitative CT bone imaging parameters combined with BMD have high predictive value for secondary fractures after PVP in patients with thoracolumbar fractures,and can provide a reference for early clinical prediction of the risk of secondary fractures after PVP.
Keywords：Thoracolumbar fracturePercutaneous vertebroplastySecondary fractureVertebral wedge angleCom-pression ratio of vertebral bodyIncreased value of spinous process distanceIncreased value of pedicle distance
Publication Date：2024-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 78-83 )