Volume 22 Issue 5
May  2024
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(5): 725-728
LIU Deguo, XU Tianbo, ZHANG Jiehong, LYU Ao, ZHENG Yuxiang, HOU Zhenhai, LU Yisheng. Preoperative assessment of bone mass in patients with lumbar internal fixation by MRI VBQ score[J]. Chinese Journal of General Practice, 2024, 22(5): 725-728. doi: 10.16766/j.cnki.issn.1674-4152.003489
Citation: LIU Deguo, XU Tianbo, ZHANG Jiehong, LYU Ao, ZHENG Yuxiang, HOU Zhenhai, LU Yisheng. Preoperative assessment of bone mass in patients with lumbar internal fixation by MRI VBQ score[J]. Chinese Journal of General Practice, 2024, 22(5): 725-728. doi: 10.16766/j.cnki.issn.1674-4152.003489
shu

Preoperative assessment of bone mass in patients with lumbar internal fixation by MRI VBQ score

doi: 10.16766/j.cnki.issn.1674-4152.003489

  • Department of Orthopaedics, the 903rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Hangzhou, Zhejiang 310004, China

Funds:

 2022KY1031

  • Received Date: 2023-11-05
    Available Online: 2024-07-20
    Abstract
  •   Objective  To evaluate the value of MRI vertebral bone quality (VBQ) score in preoperative bone mass assessment of patients with lumbar internal fixation surgery provides a basis for clinical preoperative evaluation of bone mass in such patients.  Methods  We selected and evaluated clinical data from 83 patients who underwent lumbar internal fixation at the 903rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from February 2019 to August 2022.The patients were categorized into two groups based on whether the lowest value was less than-1.0:the low-density group (T value < -1.0), including cases with osteopenia and osteoporosis (51 cases), and the normal group (T value ≥-1.0, 32 cases).Prior to surgery, all patients underwent dual-energy X-ray absorptiometry (DEXA) and MRI.We compared the clinical characteristics (age, gender, BMI) and imaging data between the two groups.Pearson correlation was used to analyze the relationship between the VBQ score and various DEXA T value.Additionally, we constructed a receiver operating characteristic (ROC) curve to assess the predictive value of VBQ scores for osteopenia.  Results  There was no significant differences in age, BMI, gender, history of diabetes, and other clinical characteristics between the normal group and the low-density group (P>0.05).The low-density group exhibited lower DEXA femoral neck T values and DEXA overall hip T values compared to the normal group, while the VBQ score was higher in the low-density group (P < 0.05).A negative correlation was observed between the VBQ score and the DEXA femoral neck T value as well as the overall hip T value (P < 0.05).The ROC curve analysis showed that the VBQ score had an AUC area of 0.842(95%CI: 0.754-0.930) for predicting abnormal bone mass (osteopenia and osteoporosis), with a sensitivity of 70.60% and specificity of 68.80%.  Conclusion  The VBQ score demonstrates effective differentiation between patients with normal bone mass and those with osteopenia, while also exhibiting correlation with the DEXA T score of patients.This provides a valuable reference for preoperative bone mass assessment in patients undergoing clinical lumbar internal fixation.

     

    • FullText(HTML)
  • loading
    • References(26)
  • [1]
    张雪琴, 胡吉学, 高伟, 等. 重庆北碚地区中老年人群的定量CT骨密度与脆性骨折评价[J]. 中国骨质疏松杂志, 2021, 27(6): 803-807. doi: 10.3969/j.issn.1006-7108.2021.06.005

    ZHANG X Q, HU J X, GAO W, et al. Evaluation on the quantitative CT bone mineral density and fragility fracture in the middle-aged and elderly populations in Beibei district, Chongqing[J]Chinese Journal of Osteoporosis, 2021, 27(6): 803-807. doi: 10.3969/j.issn.1006-7108.2021.06.005
    [2]
    丁红涛, 海涌, 刘玉增, 等. 腰椎后路融合术应用皮质骨轨迹螺钉内固定对邻近节段退变的影响[J]. 中华医学杂志, 2020, 100(43): 3437-3442. doi: 10.3760/cma.j.cn112137-20200417-01218

    DING H T, HAI Y, LIU Y Z, et al. Effect of posterior lumbar fusion on the degeneration of adjacent segments using cortical bone trajectory screw fixation[J]. National Medical Journal of China, 2020, 100(43): 3437-3442. doi: 10.3760/cma.j.cn112137-20200417-01218
    [3]
    WANG H, ZOU D, SUN Z, et al. Hounsfield unit for assessing vertebral bone quality and asymmetrical vertebral degeneration in degenerative lumbar scoliosis[J]. Spine, 2020, 75(4): 1091-1093.
    [4]
    吕永威, 杨淑辉, 马超, 等. 基于MRI的椎体骨质量分数在腰椎手术前骨量评估中的作用[J]. 中国医刊, 2021, 56(9): 984-987. doi: 10.3969/j.issn.1008-1070.2021.09.017

    LYU Y W, YANG S H, MA C, et al. MRI-based score for evaluation of bone quality before lumbar surgery[J]. Chinese Journal of Medicine, 2021, 56(9): 984-987. doi: 10.3969/j.issn.1008-1070.2021.09.017
    [5]
    王平川, 王俊武, 石鹏志, 等. 基于腰椎MRI影像评估骨密度的新型评分方法[J]. 中国医师杂志, 2022, 24(5): 667-671. doi: 10.3760/cma.j.cn431274-20210729-00820

    WANG P C, WANG J W, SHI P Z, et al. A new scoring system based on lumbar MRI image to assess bone mineral density[J]. Journal of Chinese Physician, 2022, 24(5): 667-671. doi: 10.3760/cma.j.cn431274-20210729-00820
    [6]
    EHRESMAN J, AHMED A K, LUBELSKI D, et al. Vertebral bone quality score and postoperative lumbar lordosis associated with need for reoperation after lumbar fusion[J]. World Neurosurgery, 2020, 140(8): 7159-7160.
    [7]
    CARLSON B B, SALZMANN S N, SHIRAHATA T, et al. Prevalence of osteoporosis and osteopenia diagnosed using quantitative CT in 296 consecutive lumbar fusion patients[J]. Neurosurg Focus, 2020, 49(2): 5. doi: 10.3171/2020.5.FOCUS20241
    [8]
    蒋晓莉, 肖建伟, 张树桐, 等. 腰椎间隙感染患者MRI影像学特点及手术治疗的临床疗效观察[J]. 中华医院感染学杂志, 2019, 29(2): 273-276. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY201902028.htm

    JIANG X L, XIAO J W, ZHANG S T, et al. MRI characteristics of patients with lumbar intervertebral infection and clinical effect of surgical treatment[J]. Chinese Journal of Nosocomiology, 2019, 29(2): 273-276. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY201902028.htm
    [9]
    齐建国, 张林, 隋志伟. 应用MSCT平扫、X线平片检查对腰椎滑脱术前评估及术后复查价值探讨[J]. 中国CT和MRI杂志, 2019, 17(11): 146-149. doi: 10.3969/j.issn.1672-5131.2019.11.045

    QI J G, ZHANG L, SUI Z W. Value of MSCT plain scan and X-ray plain film examination for preoperative evaluation and postoperative reexamination of spondylolisthesis[J]. Chinese Journal of CT and MRI, 2019, 17(11): 146-149. doi: 10.3969/j.issn.1672-5131.2019.11.045
    [10]
    王旸, 邹丹丹, 耿海涛, 等. MRI腰部成像参数与腰椎间盘突出症患者椎间孔镜术后疗效的关系[J]. 山东医药, 2021, 61(17): 58-61. doi: 10.3969/j.issn.1002-266X.2021.17.015

    WANG Y, ZOU D D, GENG H T, et al. Relationship between lumbar MRI imaging parameters and postoperative effect of lumbar disc herniation with foraminoscopy[J]. Shandong Medical Journal, 2021, 61(17): 58-61. doi: 10.3969/j.issn.1002-266X.2021.17.015
    [11]
    EHRESMAN J, PENNINGTON Z, SCHILLING A T, et al. Novel MRI-based score for assessment of bone density in operative spine patients[J]. Spine J, 2020, 20(4): 556-562. doi: 10.1016/j.spinee.2019.10.018
    [12]
    杨俊松, 陈浩, 刘鹏, 等. 经皮椎体成形术治疗胸腰椎骨质疏松性椎体压缩骨折疗效不佳的多因素分析[J]. 中国脊柱脊髓杂志, 2020, 30(1): 45-52. doi: 10.3969/j.issn.1004-406X.2020.01.07

    YANG J S, CHEN H, LIU P, et al. Multivariate analysis of poor relief of back pain after percutaneous vertebroplasty for thoracolumbar osteoporotic vertebral compression fracture[J]. Chinese Journal of Spine and Spinal Cord, 2020, 30(1): 45-52. doi: 10.3969/j.issn.1004-406X.2020.01.07
    [13]
    袁伟, 代耀军, 张威, 等. 腰椎间盘突出症术前磁共振检查结果与内窥镜切除术后3年内再手术风险的相关性[J]. 颈腰痛杂志, 2020, 41(2): 221-223. doi: 10.3969/j.issn.1005-7234.2020.02.028

    YUAN W, DAI Y J, ZHANG W, et al. Association of preoperative magnetic resonance imaging results with the risk of reoperation within 3 years after endoscopic resection for lumbar disc herniation[J]. The Journal of Cervicodynia and Lumbodynia, 2020, 41(2): 221-223. doi: 10.3969/j.issn.1005-7234.2020.02.028
    [14]
    EHRESMAN J, SCHILLING A, YANG X, et al. Vertebral bone quality score predicts fragility fractures independently of bone mineral density[J]. Spine J, 2020, 21(1): 20-27.
    [15]
    ORAVEC D, ZAUEL R, FLYNN M J, et al. Vertebral stiffness measured via tomosynthesis-based digital volume correlation is strongly correlated with reference values from micro-CT-based DVC[J]. Med Eng Phys, 2020, 84(5): 103-106.
    [16]
    陶洁娣, 袁袁. MRI检测在腰间盘突出症术前诊断及术后效用评估中的价值分析[J]. 分析仪器, 2021, 1(5): 119-120. doi: 10.3969/j.issn.1001-232x.2021.05.024

    TAO J D, YUAN Y. Value of MRI in preoperative diagnosis and postoperative utility evaluation of lumbar disc herniation[J]. Analytical Instrumentation, 2021, 1(5): 119-120. doi: 10.3969/j.issn.1001-232x.2021.05.024
    [17]
    梅凌, 倪涛, 董晓俊, 等. 腰椎退行性疾病患者行内固定配合椎间植骨融合术后CT影像学效果评价[J]. 中国CT和MRI杂志, 2021, 19(4): 144-146. doi: 10.3969/j.issn.1672-5131.2021.04.044

    MEI L, NI T, DONG X J, et al. Evaluation of CT imaging in patients with lumbar degenerative diseases after internal fixation combined with interbody fusion[J]. Chinese Journal of CT and MRI, 2021, 19(4): 144-146. doi: 10.3969/j.issn.1672-5131.2021.04.044
    [18]
    穆月明, 阎崇楠, 刘齐, 等. 椎旁肌影像学参数的评估及其与腰椎手术关系的研究进展[J]. 脊柱外科杂志, 2021, 19(1): 68-72. doi: 10.3969/j.issn.1672-2957.2021.01.0012

    MU M Y, YAN CN, LIU Q, et al. Evaluation of imaging parameters of paravertebral muscles and their relationship with lumbar surgery[J]. Journal of Spinal Surgery, 2021, 19(1): 68-72. doi: 10.3969/j.issn.1672-2957.2021.01.0012
    [19]
    段亮, 范亚一, 徐洪海, 等. 症状型腰椎间盘突出症应用腰椎过伸过屈位MRI的诊断价值及手术治疗效果[J]. 中华实用诊断与治疗杂志, 2019, 33(9): 911-914. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201909020.htm

    DUAN L, FAN Y Y, XU H H, et al. Role of lumbar dynamic position MRI in the diagnosis and treatment of symptomatic lumbar disc herniation and the surgical outcome[J]. Journal of Chinese Practical Diagnosis and Therapy, 2019, 33(9): 911-914. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201909020.htm
    [20]
    张志虎, 王超, 郭丽媛, 等. 极外侧型腰椎间盘突出症MRI分析及射频消融手术疗效观察[J]. 宁夏医科大学学报, 2022, 44(4): 429-432. https://www.cnki.com.cn/Article/CJFDTOTAL-XNXY202204020.htm

    ZHANG Z H, WANG C, GUO L Y, et al. Analysis of MRI and therapeutic effect of radiofrequency ablation of extra-lateral lumbar disc herniation[J]. Journal of Ningxia Medical University, 2022, 44(4): 429-432. https://www.cnki.com.cn/Article/CJFDTOTAL-XNXY202204020.htm
    [21]
    赵啸, 章振林. 基于骨折风险评估工具(FRAX®)的上海地区中老年人骨质疏松性骨折发生风险研究[J]. 中国全科医学, 2020, 23(19): 2429-2434. doi: 10.12114/j.issn.1007-9572.2020.00.090

    ZHAO X, ZHANG Z L. Osteoporotic fracture risk prediction value of fracture risk assessment tool(FRAX®)in middle-aged and elderly people in Shanghai[J]. Chinese General Practice, 2020, 23(19): 2429-2434. doi: 10.12114/j.issn.1007-9572.2020.00.090
    [22]
    王丹, 蔡贤华, 蒋欣浩, 等. 腰椎后路椎间融合内固定术后融合器后移处理23例[J]. 中国中医骨伤科杂志, 2021, 29(7): 68-71, 74. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZG202107016.htm

    WANG D, CAI X H, JIANG X H, et al. Treatment strategy of posterior cage migration following posteriorlumbar interbody fusion: a report of 23 cases[J]. Chinese Journal of Traditional Medical Traumatology & Orthopedics, 2021, 29(7): 68-71, 74. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZG202107016.htm
    [23]
    孙振国, 杨红航, 李恒, 等. 腰椎定量CT对骨质疏松性胸腰椎骨折行椎体成形术的指导意义[J]. 中国骨伤, 2020, 33(2): 111-115. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGU202002004.htm

    SUN Z G, YANG H H, LI H, et al. Guiding significance of lumbar quantitative computed tomography in percutaneous vertebroplasty for osteoporotic vertebral compression fractures[J]. China Journal of Orthopaedics and Traumatology, 2020, 33(2): 111-115. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGU202002004.htm
    [24]
    COAN P. High-Spatial-Resolution three-dimensional imaging of human spinal cord and column anatomy with postmortem X-ray phase-contrast Micro-CT[J]. Radiology, 2020, 298(1): 95-96.
    [25]
    安忠诚, 朱宇尘, 张英健, 等. 胸腰椎AO脊柱损伤评分和胸腰椎损伤分型及评分指导胸腰椎骨折手术的可信度和可重复性分析[J]. 中华创伤杂志, 2020, 36(4): 296-302. doi: 10.3760/cma.j.issn.1001-8050.2020.04.003

    AN Z C, ZHU Y C, ZHANG Y J, et al. Reliability and repeatability analysis of thoracolumbar AOSpine injury score and thoracolumbar injury severity score in guiding thoracolumbar fracture surgery[J]. Chinese Journal of Trauma, 2020, 36(4): 296-302. doi: 10.3760/cma.j.issn.1001-8050.2020.04.003
    [26]
    张晓盼, 刘良, 程敬亮. 不同成像技术在腰椎金属植入物患者MRI中应用[J]. 生物医学工程与临床, 2019, 23(5): 534-538. https://www.cnki.com.cn/Article/CJFDTOTAL-SGLC201905008.htm

    ZHANG X P, LIU L, CHENG J L. Application of different imaging techniques in MRI detection of patients with lumber spine metallic implants[J]. Biomedical Engineering and Clinical Medicine, 2019, 23(5): 534-538. https://www.cnki.com.cn/Article/CJFDTOTAL-SGLC201905008.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (83) PDF downloads(4) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return