骨质疏松性椎体压缩骨折的Micro-CT影像学参数分析

摘要

Objective To preliminarily illustrate the differences in bone quality among patients with osteoporotic vertebral compression fractures (OVCF),patients with osteoporosis,and patients without osteoporosis.Methods Thirty patients who needed to receive spinal operation were divided into 3 groups:OVCF group,osteoporosis (OP) group,and non-osteoporosis (NOP) group (n =10 in each group).Vertebra samples at equal size were extracted from every patient who had signed informed consent,which would not influence the operation effect.Extracted vertebral samples were undergone micro-computed tomography (micro-CT) to collect information of the bone mineral density (BMD),bone mineral content (BMC),and trabecular structure.Results BMD and BMC of cortical,cancellous,trabecular,and total bone decreased significantly in OVCF patients compared to those in patients of OP and NOP group (P ＜ 0.05).Amongst these parameters,trabecular BMD,cortical BMC,cancellous BMC,and total BMC decreased more significantly (P ＜ 0.01).BMD and BMC of cortical,cancellous,trabecular,and total bone decreased significantly in OP group compared to those in NOP group (P ＜ 0.05),among which trabecular BMD showed the most significant decrease (P ＜ 0.01).Conclusion Relatively low levels of BMD and BMC are vital contributing factors to osteoporotic vertebral compression fractures.Patients with osteoporosis should pay attention to prevent decrease in BMD and BMC in order to reduce the risk of osteoporotic vertebral compression fractures.%目的 初步探讨骨质疏松性椎体压缩骨折患者、骨质疏松患者以及无骨质疏松患者3者间椎体骨质的差别.方法 对30例需要进行手术治疗的患者进行分组,分别为骨质疏松性椎体压缩骨折患者组、骨质疏松患者组及无骨质疏松患者组,每组10例.在术中分别取出3组患者少许椎体样本,椎体样本大小相等,不影响手术疗效的同时亦不会对患者造成不良影响,患者均表示知情同意.随后分别对取出的椎体标本进行显微计算机断层扫描术(micro-computed tomography,Micro-CT)检测,以了解及对比3组患者之间椎体骨密度(bone mineral density,BMD)、骨矿含量(bone mineral content,BMC)和骨小梁情况.结果 骨质疏松性椎体压缩骨折患者组对比骨质疏松患者组、无骨质疏松患者组其椎体皮质骨BMD、松质骨BMD、骨小梁BMD和总体BMD以及皮质骨BMC、松质骨BMC和总BMC均有明显下降,差异具有统计学意义(P＜0.05),其中骨小梁BMD、皮质骨BMC、松质骨BMC和总BMC下降显著(P＜0.01);骨质疏松患者组对比无骨质疏松患者组其椎体皮质骨BMD、松质骨BMD、骨小梁BMD和总体BMD以及皮质骨BMC、松质骨BMC和总BMC均有下降,差异具有统计学意义(P＜0.05),其中骨小梁BMD下降显著(P＜0.01).结论 较低的椎体BMD和BMC是椎体压缩骨折发生发展的主要原因,骨质疏松患者和暂无骨质疏松人群需要预防BMD、BMC的下降,防止骨质疏松性椎体压缩骨折的发生.