Reference intervals of adjacent disc height in fresh osteoporotic vertebral compression fractures and the association with postoperative adjacent segment complications: a quantitative study in Chinese postmenopausal women.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2024-11-13 DOI:10.1186/s13018-024-05248-z

Ruiyuan Chen, Tianyi Wang, Ning Fan, Aobo Wang, Lei Zang, Shuo Yuan

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Abstract

Background: Preoperative adjacent disc height (DH) was found as an independent risk factor for adjacent segment degeneration (ASD) after percutaneous kyphoplasty (PKP), indicating the preoperative status of the adjacent intervertebral discs may be closely related to adjacent segment complications. To establish the reference intervals (RIs) for adjacent DH of fresh osteoporotic vertebral compression fracture (OVCF) in Chinese postmenopausal women, and investigate the association with adjacent segment complications after PKP.

Methods: Consecutive inpatients diagnosed with fresh OVCF between November 2015 and August 2023 were reviewed. The enrolled patients were divided into subgroups based on injured vertebral level; then, the cranial and caudal DH were measured. The characteristics of DH among subgroups were identified, and specific RIs were established using the indirect Hoffmann method. The associations between DH and adjacent segment complications were assessed using multivariate analysis.

Results: The DH of the cranial disc was significantly lower than the corresponding caudal disc in all vertebral levels, which showed an increasing trend from T11 to L4. The RIs of DH were as follows: T11 (cranial), 2.14-5.14 mm; T11 (caudal), 2.64-5.89 mm; T12 (cranial), 2.69-5.77 mm; T12 (caudal), 3.18-6.57 mm; L1 (cranial), 3.05-6.59 mm; L1 (caudal), 3.40-8.29 mm; L2 (cranial), 3.68-8.36 mm; L2 (caudal), 4.57-9.78 mm; L3 (cranial), 4.53-8.92 mm; L3 (caudal), 5.26-10.07 mm; L4 (cranial), 4.70-11.42 mm; and L4 (caudal), 5.52-12.12 mm. Increased risks of adjacent segment complications after PKP were observed in patients with decreased adjacent DH.

Conclusion: The estimated vertebral level and disc level-specific RIs for adjacent DH of fresh OVCF were established in the Chinese postmenopausal women population. A decrease in adjacent DH posed high risks of adjacent segment complications after PKP for treating OVCF.

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新鲜骨质疏松性椎体压缩骨折邻近椎间盘高度的参考区间及与术后邻近节段并发症的关系：一项针对中国绝经后女性的定量研究。

背景：研究发现，术前邻近椎间盘高度（DH）是经皮椎体后凸成形术（PKP）术后邻近节段退变（ASD）的独立危险因素，表明邻近椎间盘的术前状态可能与邻近节段并发症密切相关。目的：建立中国绝经后女性新鲜骨质疏松性椎体压缩骨折（OVCF）邻近DH的参考区间（RIs），并研究其与PKP术后邻近节段并发症的关联：回顾性分析2015年11月至2023年8月期间诊断为新鲜OVCF的连续住院患者。方法：对 2015 年 11 月至 2023 年 8 月期间诊断为新鲜 OVCF 的住院患者进行回顾性研究，根据受伤椎体的水平将入组患者分为亚组，然后测量头颅和尾椎的 DH。确定了亚组之间 DH 的特征，并使用间接 Hoffmann 法确定了特定的 RI。采用多变量分析评估了 DH 与邻近节段并发症之间的关系：结果：在所有椎体水平上，颅侧椎间盘的 DH 均明显低于相应的尾侧椎间盘，且从 T11 到 L4 呈上升趋势。DH的RIs如下：T11（头颅），2.14-5.14 mm；T11（尾椎），2.64-5.89 mm；T12（头颅），2.69-5.77 mm；T12（尾椎），3.18-6.57 mm；L1（头颅），3.05-6.59 mm；L1（尾椎），3.40-8.29毫米；L2（头颅），3.68-8.36毫米；L2（尾椎），4.57-9.78毫米；L3（头颅），4.53-8.92毫米；L3（尾椎），5.26-10.07毫米；L4（头颅），4.70-11.42毫米；L4（尾椎），5.52-12.12毫米。在邻近DH减少的患者中观察到PKP术后邻近节段并发症的风险增加：结论：在中国绝经后女性人群中建立了新鲜OVCF邻近DH的椎体水平和椎间盘水平特异性RI估计值。结论：在中国绝经后女性人群中建立了新鲜OVCF邻近DH的估算椎体水平和椎间盘水平特异性RI，邻近DH降低会导致PKP治疗OVCF后邻近节段并发症的高风险。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.