Hounsfield单位在预测andersond 'Alonzo II型和浅型III型骨折后行前齿状突螺钉固定患者融合率中的应用

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Journal of neurosurgical sciences Pub Date : 2023-06-01 DOI:10.23736/S0390-5616.20.05190-5
Jan Lodin, Aleš Hejčl, Martin Bolcha, Martin Sameš, Petr Vachata
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引用次数: 1

摘要

背景:本研究的主要目的是确定在椎轴三个区域测量的Hounsfield单位(HU)是否与II型和浅III型C2骨折接受前齿状突螺钉固定(AOSF)的患者成功融合相关。方法:对45例经AOSF治疗的C2骨折患者进行分析。只有骨融合与骨小梁跨越骨折线被认为是成功的结果。术前测量体、分水岭和牙穴三个区域的HU值。通过统计分析确定融合和未融合患者在所有三个区域的HU之间的显著差异。结果:完全队列与调整队列的融合(语料库- 363.7,分水岭- 327.9)与未融合(语料库- 279.5,分水岭- 194.2)的HU值差异有统计学意义。计算分水岭区完整队列(250和300)和调整队列(240和260)的截止HU值,将患者按骨质量分为三组。高分水岭骨质量(HU>300)患者的融合率为84.62%,低分水岭骨质量(HU)患者的融合率为84.62%。结论:术前测量HU可用于预测II型和浅III型C2骨折AOSF患者的融合率。对于分水岭HU>300的患者,AOSF是一种非常有效的治疗方式,而对于分水岭HU患者,应考虑其他治疗方式
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Utility of Hounsfield units in predicting fusion rates of patients undergoing anterior odontoid screw fixation following Anderson d'Alonzo type II and shallow type III fractures.

Background: Main objective of this study was to determine whether Hounsfield units (HU) measured in three areas of the axis correlate with successful fusion in patients with type II and shallow type III C2 fractures undergoing anterior odontoid screw osteosynthesis (AOSF).

Methods: Forty-five patients with C2 fractures treated via AOSF were analyzed. Only bony fusion with bone trabeculations across the fracture line was considered a successful result. Preoperative HU values were measured in three zones- corpus, watershed and dens. Statistical analysis was performed to determine significant differences between HU of fused and unfused patients in all three zones of a complete and adjusted patient cohort.

Results: Statistically significant differences of HU values were found between fused (corpus- 363.7, watershed- 327.9) and unfused (corpus- 279.5, watershed- 194.2) of the complete cohort and the adjusted cohort. Cut-off HU values in the watershed zone were calculated for the complete (250 and 300) and adjusted cohort (240 and 260), dividing patients into three groups of bone quality. Patients with high watershed bone quality (HU>300) achieved successful fusion in 84.62%, patients with low bone quality (HU<250) in 3.85% and patients with medium bone quality (HU 250-300) in 50%.

Conclusions: Preoperative measurement of HU can be used to predict the probability of successful fusion in patients undergoing AOSF for type II and shallow type III C2 fractures. AOSF is a highly effective treatment modality in patients with watershed HU>300, whereas alternatives should be considered in patients with watershed HU<250.

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来源期刊
Journal of neurosurgical sciences
Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY
CiteScore
3.00
自引率
5.30%
发文量
202
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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