分步体位复位椎体成形术治疗胸腰椎压缩性骨折

目的探讨分步体位复位经皮椎体成形术治疗胸腰椎椎体压缩性骨折的临床效果。方法90例胸腰椎椎体骨折患者分2步体位复位,经单侧椎弓根穿刺向椎体注入聚甲基丙烯酸甲酯,手术前后用影像学资料评估伤椎椎体高度恢复率、后凸角度矫正率,用视觉模拟分级法（visual analogue scale,VAS）评估疼痛程度。结果手术均获成功,伤椎椎体前缘高度恢复率为（85．6±12．6）％,椎体中线高度恢复率为（86．6±9．7）％,后凸角度矫正率为（62．2±23．5）％,与术前相比差异均有统计学意义（P〈0．05）,无并发症发生。术后1周VAS评分为2．6±0．2分,与术前8．2±0．2分相比差异有统计学意义（t=21．95,P〈0．01）。82例患者术后获得随访,平均随访36．3个月,胸腰背疼痛无复发,椎体高度无改变,邻椎无骨折。结论分步体位复位经皮椎体成形术能恢复椎体高度,矫正后凸畸形,消除疼痛,增加椎体强度和脊柱稳定性。是治疗胸腰椎椎体骨折经济、安全、有效的方法。     

分步体位复位椎体成形术治疗胸腰椎压缩性骨折

【摘要】 目的 探讨分步体位复位经皮椎体成形术治疗胸腰椎椎体压缩性骨折的临床效果。 方法 90例胸腰椎椎体骨折患者分2步体位复位,经单侧椎弓根穿刺向椎体注入聚甲基丙烯酸甲酯,手术前后用影像学资料评估伤椎椎体高度恢复率、后凸角度矫正率,用视觉模拟分级法(visual analogue scale, VAS)评估疼痛程度。 结果 手术均获成功,伤椎椎体前缘高度恢复率为(85.6±12.6)%,椎体中线高度恢复率为(86.6±9.7)%,后凸角度矫正率为(62.2±23.5)%,与术前相比差异均有统计学意义(P<0.05),无并发症发生。术后1周 VAS评分为2.6±0.2分,与术前 8.2±0.2分相比差异有统计学意义 (t=21.95, P＜0.01)。82例患者术后获得随访,平均随访 36.3个月,胸腰背疼痛无复发,椎体高度无改变,邻椎无骨折。 结论 分步体位复位经皮椎体成形术能恢复椎体高度,矫正后凸畸形,消除疼痛,增加椎体强度和脊柱稳定性, 是治疗胸腰椎椎体骨折经济﹑安全﹑有效的方法。     

Ultrasound and dual X-ray absorptiometry densitometry in women with hip fracture

To assess the usefulness of the measurement of the os calcis by ultrasound, a method that probably reflects bone quality as well as density, we have studied 54 women with hip fracture of the proximal femur and a control group. Ultrasound evaluation of the os calcis [broadband ultrasound attenuation (BUA), speed of the sound (SOS), and a combined index (stiffness)], and bone mineral density (BMD) determination over the proximal femur by dual X-ray absorptiometry (DXA) were performed. Weight, BMD, and ultrasound values in the hip fracture patients were significantly lower than controls (P<0.001). The Z-scores for BUA and stiffness were not different than that for femoral neck. Ward's triangle or trochanteric BMD (between-1.7 and -1.5). The odds ratios determined by receiver-operating characteristics (ROC) analysis were greater at the femoral neck (25.1) and BUA (24.4). Intermediate values were found at stiffness (16.9), Ward's triangle (12.8), and trochanter (11.1), and lower values were obtained at SOS (4.2). In turn, patients with trochanteric hip fractures had a significantly lower femoral neck and Ward's triangle BMD, stiffness, and BUA than patients with cervical hip fractures. Comparing a subgroup of 30 women with hip fractures without vertebral fractures with an age-matched group of 87 women with osteoporotic vertebral fractures, both groups were of similar weight and BMD but all ultrasound values were significantly lower in the hip fractures compared with vertebral fracture patients (P<0.05-P<0.01). Our findings suggest that in women with hip fractures, ultrasound evaluation of the os calcis has diagnostic sensitivity comparable to DXA of the femur and could be useful to predict hip fracture risk. Ultrasound values are lower in hip fractures compared with vertebral fracture, age-matched women and in older compared with younger hip fracture patients.     

Evaluation of lumbar spine bone mineral density in the anteroposterior and lateral projections by dual-energy X-ray absorptiometry.

Dual-energy x-ray absorptiometry (DXA) is an established method for estimating bone mineral density (BMD) of the lumbar spine. In a prospective study, the sensitivity of BMD measurements between anteroposterior and lateral projections were evaluated in 204 postmenopausal women based on their DXA analysis. Patients were divided into two groups according to the absence or presence of lumbar scoliosis. Lateral projection DXA measurements were more sensitive than AP projection measurements for early detection of bone loss in postmenopausal women. Lateral projection DXA analysis is not recommended in spines with lumbar scoliosis.     

Evaluation of vertebral fracture assessment by dual X-ray absorptiometry in a multicenter setting

Summary  The utility of vertebral fracture assessment (VFA) by DXA to detect prevalent vertebral fracture in a multicenter setting was investigated by comparison to conventional radiography. While limited by lower image quality, overall performance of VFA was good but had a tendency to miss mild prevalent fractures. Introduction  In osteoporosis clinical trials standardized spine radiographs are used to detect vertebral fractures as a study endpoint. Lateral spine imaging with dual X-ray absorptiometry (DXA) scanners, known as vertebral fracture assessment (VFA) by DXA, presents a potential alternative to conventional radiography with lower radiation dose and greater patient convenience. Methods  We investigated in a multicenter setting the ability of VFA to detect fractures in comparison with conventional radiography. The study examined 203 postmenopausal women who had imaging of the spine by DXA and radiography. Three radiologists experienced in vertebral fracture assessment independently read the VFA scans and radiographs using the Genant semiquantitative method on two occasions. Conclusions  Analyzing the data from all readable vertebrae, the kappa statistic, sensitivity, and specificity ranged from 0.64–0.77, 0.65–0.84, and 0.97–0.98, respectively. Considering only moderate and severe fractures improved the kappa statistic (0.80–0.91) and sensitivity (0.70–0.86). While image quality of VFA is inferior to radiography, the detection of vertebral fractures using visual scoring is feasible. However, VFA underperformed due to unreadable vertebrae and reduced sensitivity for mild fractures. Nevertheless, VFA correctly identified most moderate and severe vertebral fractures. Despite this limitation, VFA by DXA provides an important tool for clinical research.     

Effects of radioisotopes on the accuracy of dual-energy X-ray absorptiometry for bone densitometry.

Nuclear medicine procedures are often performed in close-time proximity to bone densitometry studies. The purpose of this study was to determine the effects of various radioisotopes on the accuracy of bone mineral density (BMD) measurements performed using dual-energy x-ray absorptiometry (DEXA) systems. We evaluated two DEXA scanners: the Hologic QDR4500 and the Lunar Prodigy. The effects of various activities of Tc-99m, Tl-201, Ga-67 and I-131 on BMD were assessed by placing vials or syringes containing the appropriate isotope above or below a simulated spine (average BMD = 1.1 g/cm2) embedded in a lucite block. We also placed a spine phantom (average BMD = 2.0 g/cm2) in a water bath containing various concentrations of Tc-99m. Maximum activities evaluated were as follows: Tc-99m, 80 mCi; I-131, 50 mCi; Tl-201, 66 mCi; Ga-67, 20 mCi. For the Hologic QDR4500 system, irrespective of the radioisotope or activity, we found no significant effect of adjacent activity on measured BMD on this system. For the Lunar Prodigy system, the effects of adjacent activity on BMD were found to be dependent on source location, strength, and radioisotope. For sources placed beneath the solid lucite phantom, BMD decreased by approx 0.5%/10 mCi of activity for all isotopes. In general, for sources placed above the lucite phantom, the BMD decreased by 1.6-4.0%/10 mCi of activity, depending on location. The exception was Tl-201, where BMD increased by 0.5-2.5%/10 mCi, depending on location. With the high-density spine in the water phantom, the effects of adjacent activity were more pronounced than in the standard density spine in the lucite block. For a distributed Tc-99m source, the BMD decreased by 1.7%/10 mCi. The effect of radioactivity on DEXA measurements is system dependent. In general, adjacent activity results in a reduction in apparent BMD. The magnitude of the effect increases with increasing BMD and is dependent on the location of the activity.     

河南地区正常人腰椎前后位和侧位及侧位中部区域骨密度的检测分析

目的 了解河南正常人群腰椎前后位、腰椎侧位及腰椎侧位椎体中部区域骨密度数据，为该部位骨质疏松的诊断提供正常参考值。方法 应用Hologic公司生产的4500W型双能X线骨密度仪，对河南地区居住10年以上1141名正常人作了腰椎前后位骨密度检测；960名正常人作了腰椎侧位骨密度检测，其中714人作了腰椎体侧位椎体中部区域骨密度分析。结果 腰椎前后位骨密度女性组于30－39岁达峰值；男性组于40－49岁达峰值。腰椎侧位和侧位区域骨密度不管男组和女组，均在30－39岁达峰值，峰值后随年龄增长骨密度逐渐降低；各年龄段腰椎侧位和侧位区域骨密度值男性均高于女性。结论 检测结果为该地区诊断腰椎前后位、腰椎侧位和侧位区域骨质疏松提供了正常参照值。     

Morphometric X-ray absorptiometry and morphometric radiography of the spine: a comparison of prevalent vertebral deformity identification.

Prevalent vertebral deformities are associated with a substantially increased risk of subsequent vertebral and nonvertebral fractures. Knowledge of vertebral fracture status is an important component in the prediction of further fractures in patients with osteoporosis. This study reports a comparison of the quantitative identification of vertebral deformities on morphometric X-ray absorptiometry (MXA) scans and conventional radiographs (MRX) in 161 postmenopausal women (mean age +/- SD, 64 +/- 7.1 years) recruited from patients referred by their family doctor for bone density measurement (n = 119) and osteoporotic subjects with known vertebral deformities attending an osteoporosis clinic (n = 42). Each subject had MXA scans and MRXs of the thoracolumbar spine, to image the vertebrae from T4-L4, at a single visit. The scans and radiographs were analyzed by two trained observers using six points to quantify the shape of each vertebral body. From these points, three vertebral heights were measured: anterior, middle, and posterior. Vertebral deformities were identified using the algorithms proposed by Eastell and by McCloskey. Generally good to excellent agreement (per vertebra, kappa = 0.87-0.93; per subject, kappa = 0.81-0.91) was observed between the two algorithms used for quantitative vertebral deformity identification using MXA or MRX. More moderate agreement (per vertebra, kappa = 0.70-0.79; per subject, kappa = 0.67-0.75) was seen when comparing the same algorithm between MXA and MRX. Agreement between MXA and MRX for the McCloskey algorithm was better than for the Eastell algorithm, largely because of the lower number of false positives produced by the McCloskey methodology. Deformity identification by MXA was limited because of poor image quality, primarily in the upper thoracic spine. One in six MRX deformities were missed by MXA as they occurred in vertebrae not visualized sufficiently for analysis on the MXA scans. Deformity identification was poorer in the upper thoracic spine in analyzable vertebrae with a sensitivity of 50.0% for MXA in terms of MRX using the Eastell algorithm for the vertebral levels T4-T7, compared with 80.6% for L1-L4A. MXA proved to be more effective at identifying moderate to severe MRX deformities producing a sensitivity of 22.0% for MXA in terms of identifying MRX grade 1 deformities using the Eastell algorithm, compared with 81.6% for grade 2 deformities. Although MXA image quality is inferior to that of conventional radiographs, MXA has distinct advantages such as a substantially reduced effective dose to the patient and acquisition of a single image of the spine. MXA is a potentially useful, relatively fast, low-radiation technique to identify prevalent vertebral deformities, particularly moderate to severe deformities in the middle/lower thoracic and lumbar spine, in conjunction with morphometric radiography in some patients.     

骨质疏松性椎体压缩骨折迟发性后凸畸形的危险因素分析

目的探讨导致骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)迟发性后凸畸形的危险因素。方法回顾性研究我院2015年1月至2017年1月符合选择标准纳入研究的137例行保守治疗OVCFs患者的临床和影像资料,根据随访结果按有无后凸畸形(椎体局部后凸角≥30°)将患者分为后凸畸形组和对照组。首先采用独立样本t检验和卡方检验对相关危险因素进行统计学分析,这些相关危险因素包括年龄、体质量指数(body mass index,BMI)、骨密度(bone mineral density,BMD)、视觉模拟评分法(visual analogue scale,VAS)末次随访评分、Oswestry功能障碍指数(oswestry disability index,ODI)末次随访评分、骨折椎体高度初始丢失率、性别、胸腰段骨折、既往邻近椎体骨折、骨折分型、椎体后壁骨折、长期使用糖皮质激素。将有统计学意义的危险因素引入Logistic回归分析得出椎体后凸畸形的主要危险因素。结果所有患者均获超过6个月以上随访,最终共计73例(53.3%)患者出现后凸畸形。独立样本t检验及卡方检验统计分析显示,BMD、胸腰段骨折、骨折分型、椎体后壁骨折、长期使用糖皮质激素与后凸畸形相关(P0.05)。而年龄、性别、BMI、VAS末次随访评分、ODI末次随访评分、骨折椎体高度初始丢失率、既往邻近椎体骨折与后凸畸形无相关性(P0.05)。Logistic回归分析发现胸腰段骨折、椎体后壁骨折、长期使用糖皮质激素与后凸畸形显著相关(P0.05),优势比分别为16.129、21.562、5.922。结论胸腰段骨折、椎体后壁骨折、长期使用糖皮质激素是OVCFs迟发性后凸畸形的高危因素。     

Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA)

Measurement of bone mineral density (BMD) with central dual-energy X-ray absorptiometry (DXA) is the current gold standard for diagnosing osteoporosis and for monitoring patients. Errors in demographic information, improper patient positioning, incorrect scan analysis, and mistakes in interpretation can all lead to a wrong clinical decision or action. This paper reviews the fundamentals of positioning, scan analysis, and interpretation for central DXA and highlights some of the common pitfalls that may lead to erroneous results.     

胸腰椎压缩性骨折脊柱后凸成形术的临床分析

目的探讨胸腰椎压缩性骨折脊柱后凸成形术的优势及并发症。方法选取2009年1月～2011年5月52例接受脊柱后凸成形术的胸腰椎压缩性骨折患者。结果 52例患者均完成脊柱后凸成形术,1例术后发生脊柱前骨水泥渗漏,1例术后发生脊柱后骨水泥＂尾巴＂,未造成脊髓硬膜囊受压、疼痛等后遗症,52例患者随访1～18个月,平均6个月,无复发。结论脊柱后凸成形术不仅具有椎体成形术的优点,还恢复压缩椎体的强度和刚度,又可部分恢复压缩椎体的高度,矫正后凸畸形。但脊柱后凸成形术又存在骨水泥渗漏、肺栓塞、脊髓损伤、局部出血和血肿、疼痛加重、一过性发热等并发症。     

Comparison of nuclear magnetic resonance spectroscopy with dual-photon absorptiometry and dual-energy X-ray absorptiometry in the measurement of thoracic vertebral bone mineral density: Compressive force versus bone mineral

³¹P nuclear magnetic resonance spectroscopy (NMRS) measurements were made on human T2 and T3 vertebral bodies. The bone mineral content (BMC) of isolated vertebral bodies minus the posterior elements and disks was measured using (1) NMRS on a 3.5 T, 85 mm bore GE Medical Systems NT-150 superconducting spectrometer, (2) a Lunar Corporation DPX-L dual-energy X-ray absorptiometry (DXA) scanner in an anterior-posterior (AP) orientation, (3) a Norland Corporation XR26 DXA scanner, also in an AP direction, and (4) a Norland Corporation model 2600 dual-photon absorptiometry (DPA) densitometer in both the AP and superior-inferior (SI) directions. Vertebral body volumes were measured using a water displacement technique to determine volume bone mineral densities (VBMD). They were then compressed to failure using an electrohydraulic testing device, followed by ashing in a muffle furnace at 700 °C for 18 h. Correlations of BMC between NMRS and DPA, DXA and ashing were excellent (0.96r0.99); in a one-way analysis of variance (ANOVA) test, means were not statistically different at ap level of 0.757. The correlations of VBMD between NMRS and the other methods were not as good (0.83r0.95); in a one-way ANOVA test, means were not statistically different at ap level of 0.089. BMC was a better predictor of ultimate compressive failure than VBMD for all six methods. For NMRS, the regression coefficient for BMC wasr ²=0.806, compared withr ²=0.505 for VBMD. NMRS may prove an alternative to present methods of determing bone mineral.     

Radiographic outcome of vertebral bone bruise associated with fracture of the thoracic and lumbar spine in adults

Bone bruising associated with long bone injury is a defined entity with known radiological, pathologic and clinical features. Vertebral bone bruise (VBB) has been described through magnetic resonance imaging (MRI) of the injured spine, but to date the consequences of this entity are unknown. The objective of this retrospective study was to describe the plain radiographic outcome of MRI-defined VBB associated with thoracic and lumbar spine fracture in adults, and to assess whether VBBs caused abnormalities of the bone–implant interface at instrumented levels. Levels of VBB were identified through analysis of the full spine MRI in a consecutive series of adult patients admitted to a spinal injuries unit for thoracic and lumbar spine fractures. The anterior wedge angles (AWAs) of thoracic and lumbar vertebrae demonstrating VBB were measured on radiographs taken at time of injury and at follow-up. Abnormalities of the bone–implant interface were recorded at instrumented levels associated with VBB on follow-up radiographs. Thirty VBBs were identified in 18 adult patients who had suffered 21 vertebral fractures. At an average follow-up of 19 months (range, 12–30 months), the mean AWAs of the VBB vertebrae at the time of injury and at the most recent follow-up were 3.5° and 3.8°, respectively (p=0.33, paired t-test). A total of 12 out of 30 (40%) bruised levels were instrumented in 13 out of 18 (72%) operated patients. No bone–implant interface failure was observed at these levels. It is concluded that VBB associated with thoracic and lumbar vertebral fracture in adult patients does not appear to cause significant progressive vertebral deformity or bone–implant interface failure.An erratum to this article can be found at     

The determination of bone fracture properties by dual-energy X-ray absorptiometry and single-photon absorptiometry: A comparative study

Summary Dual-energy X-ray absorptiometry (DEXA) and single-photon absorptiometry (SPA) were used to quantitate the structural strength and local material properties of healing tibial osteotomies in 32 dogs. Dogs were divided into four equal groups, euthanatized at either 2, 4, 8, or 12 weeks, and imaged with DEXA and SPA. Invasive techniques were used to determine (1) the torsional properties of the bone, (2) the local stiffness properties and calcium content within the bone, and (3) new bone formation and porosity by histology. There were no differences between SPA and DEXA in their associations with the torsional properties of bone. SPA and DEXA had strong correlations with the ultimate torque (R²=0.76, 0.51) and the torsional stiffness (R²=0.68, 0.53) of bone. SPA and DEXA of periosteal callus, endosteal callus, and cortical bone had similar associations with indentation stiffness, calcium content, new bone formation, and porosity. SPA of gap tissue had significantly stronger associations with these four parameters than DEXA (P<0.05). Correlation coefficients (R²) with these local material properties ranged as high as 0.82 for SPA with new bone formation in the gap tissue and 0.73 for DEXA with indentation stiffness of periosteal callus.     

Treatment of osteoporotic compression fracture of thoracic/lumbar vertebrae by kyphoplasty with SKY bone expander system

Objective： To investigate prospectively the effectiveness ofkyphoplasty with SKY bone expander system in treatment of compression fracture of thoracic/ lumbar vertebrae and correction of the deformity. Methods： Twenty-five patients with thoracic/lumbar vertebral osteoporotic compression fracture were admitted to our hospital between March 2007 and March 2008, and treated by kyphoplasty with SKY bone expander system. Patient＇s pain status was rated with Visual Analogue Scale （VAS） score system 1 day before and 1 hour, 48 hours, 6 months, 12 months after surgery. In addition, Rolland-Mor- ris and Oswestry disability questionnaires （RDQ and ODI） were used for survey 1 day before and 1, 6, 12 months after surgery. Pre- and post-operative vertebral heights and Cobb＇s angles were measured based on the X-ray films and statistically analyzed. Results： There were 27 fractured vertebrae in these 25 patients. After SKY kyphoplasty, the Cobb＇s angles （9.8°±9.76°） were significantly reduced compared with preoperative angles （17.18°±9.35°, P〈0.05）, and the average improve- ment rate was 39%. Patients＇ pain VAS scores were also greatly improved after operation （P〈0.05）. Moreover, postoperative RDQ and ODI scores were significantly smaller than preoperative values （P〈0.05）. Conclusions： Kyphoplasty with SKY bone expander system provides an effective method for treating thoracic/ lumbar vertebral osteoporotic compression fracture, with the advantages of small surgical wound and short duration. It can effectively recover the anterior and medial heights of fractured vertebrae （33% and 50%, respectively）, reduce the Cobb＇s angle, quickly alleviate pain and improve patients＇ quality of life in a relatively short time period.     

Measurement of vertebral body dimensions of the thoracic and lumbar spines of 242 healthy women

To establish diagnostic criteria for osteoporosis using roentgenograms of vertebral bodies, the posterior margin, anterior margin, and central portion heights of 14 vertebral bodies in 242 healthy women were measured. It was demonstrated that the measurement of vertebral heights using a digitizer by one expert could be made with high accuracy, based on the results of comparison between roentgenograms on a 50% reduced scale and ordinary-scale roentgenograms as well as those of daily and day-to-day variations of the measured values. According to these measurements, the seventh thoracic vertebra showed the most marked tendency toward wedge formation and the fifth lumbar vertebra toward reverse-wedge formation. In the measurement of vertebral body heights, the accuracy decreased at vertebral levels where the images of thoracic vertebral bodies are superimposed upon by the shadows of cardiovascular organs. Because the variations in measurement values in Japanese were not significant in comparison with those in European and American persons, means minus 3 SD were almost the same as means minus 25% designated in Japan with respect to the ratio of anterior to posterior margin heights of vertebral bodies. Moreover, the means minus 3 SD were almost equal to means minus 20%, with respect to the ratio of central to posterior margin heights of vertebral bodies. Thus, our conclusion is that the definition of vertebral deformity as designated in Japan is sufficiently accurate for the diagnosis of osteoporosis. Received: May 29, 1997 / Accepted: Oct. 24, 1997     

Sky膨胀式椎体成形器在骨质疏松性椎体压缩骨折重建中的初步应用

[目的]介绍一种用于重建T5-L5间的椎体压缩性骨折的新方法。[方法]12例（19椎）骨质疏松性椎体压缩骨折患者，应用Sky膨胀式椎体成形器进行椎体扩张，使用PAMMA作为填充物重建骨折椎体，比较手术前后疼痛缓解程度（VAS法）的变化与Cobbg角的变化。[结果]本组病例均获随访2—8个月，平均6个月，无1例死亡，1例出现椎管内渗漏，无神经缺失症状，均达到疼痛缓解，手术前后Cobbg角有显著差异。[结论]Sky方法具有满意的止痛效果，还能较好的纠正后突畸形，有效恢复并保持椎体高度。而且可减少患者的经济负担，操作简单，值得临床推广。     

Diagnostic value of ultrasound analysis and bone densitometry as predictors of vertebral deformity in postmenopausal women

Bone fractures depend not only on bone density, but also on bone quality. Ultrasound (US) has been proposed as a technique for evaluating skeletal status. Speed of sound (SOS) and broadband ultrasound attenuation (BUA) are the US properties currently used to assess bone strength and fragility. In 304 postmenopausal women (age 58.8±5.5 years) we measured: bone mineral density (BMD) of the lumbar spine (by dual-energy X-ray absorptiometry), SOS, BUA and Stiffness in the os calcis (using an Achilles machine). In all subjects we performed lateral lumbar and thoracic radiographs. Morphometric parameters were derived by measuring the anterior, middle and posterior height of each vertebral body, to obtain a semiquantitative grading of vertebral fractures as follows: 0, no vertebral deformity; 1, any vertebral height reduced between 20% and 25%; 2, any vertebral height reduced between 25% and 40%; 3, any vertebral height reduced more than 40%. On the basis of the number and severity of vertebral deformities the women were divided into: group 1 (n=79), normal; group 2(n=80), mild; group 3 (n=85), moderate; and group 4 (n=60), severe. Mean values of SOS, BUA, Stiffness and BMD were significantly lower (p<0.001) in women with vertebral deformity than in normals. In the whole population SOS, BUA and Stiffness values were significantly correlated with BMD. SOS, BUA and Stiffness values were significantly decreased (p<0.001) with vertebral deformity, as was BMD. Receiver operating characteristic (ROC) curve analysis showed BMD to be slightly better than Stiffness in discriminating among groups. Logistic regression analysis showed that BMD, BUA, SOS and Stiffness were independent predictors of vertebral fracture risk. Ultrasound parameters were still significant independent predictors of vertebral fracture even after adjusting for BMD.     

DXA诊断椎体压缩性骨折的应用进展

椎体压缩性骨折不仅是骨质疏松的主要临床表现之一,而且在预测骨折风险中具有重要意义,双能X线骨密度吸收仪(DXA)从最初的一种定量测量仪器发展到可以进行成像,目前已经可以用椎体侧位DXA成像来诊断椎体骨折并进行椎体骨折评估,可以更好的了解骨骼状态,而且放射暴露比普通X片低得多,本文就DXA在椎体压缩性骨折诊断方面的进展综述如下.