医学
霍恩斯菲尔德秤
放射性密度
腰椎
口腔正畸科
腰椎
骨质疏松症
椎骨
固定(群体遗传学)
射线照相术
核医学
外科
计算机断层摄影术
人口
环境卫生
内分泌学
作者
Jingchi Li,Zhuang Zhang,Tianhang Xie,Zhe-Tao Song,Yueming Song,Jiancheng Zeng
标识
DOI:10.1007/s00330-022-09157-9
摘要
Abstract Objective Screw loosening is a widely reported issue after spinal screw fixation and triggers several complications after lumbar interbody fusion. Osteoporosis is an essential risk factor for screw loosening. Hounsfield units (HU) value is a credible indicator during bone mineral density (BMD) evaluation. As compared with the general evaluation of BMD, we hypothesized that specific measurements of HU at the precise location of the future screw insertion may be a better predictor of screw loosening. Methods Clinical data of 56 patients treated by oblique lumbar interbody fusion (OLIF) of the L4-L5 segments with an anterior lateral single rod (ALSR) screw fixation were reviewed in this study. Vertebral bodies with ≥ 1 mm width radiolucent zones around the screw were defined as screw loosening. HU in the insertional screw positions, the central transverse plane, and the average values of three and four planes were measured. Regression analyses identified independent risk factors for screw loosening separately. The area under the receiver operating characteristic curve (AUC) was computed to evaluate predictive performance. Results The local HU values were significantly lower in the loosening group, regardless of the selected measuring methods. The AUC of screw loosening prediction was higher in the insertional screw positions’ HU than other frequently used methods. Conclusions The HU value measured in the insertional screw position is a better predictor of ALSR screw loosening than other methods. The risk of screw loosening should be reduced by optimizing the trajectory of the screw based on the measurement of HU in preoperative CT. Key Points • Osteoporosis is an essential risk factor for screw loosening, and Hounsfield units (HU) are a credible predictor during bone mineral density (BMD) evaluation. • The HU value measured in the insertional screw position is a better predictor of screw loosening than other frequently used HU measurement methods. • The risk of screw loosening might potentially be reduced by optimizing the trajectory of the screw based on the measurement of HU in preoperative CT.
科研通智能强力驱动
Strongly Powered by AbleSci AI