Prevalence of osteoporosis and osteopenia diagnosed using quantitative CT in 296 consecutive lumbar fusion patients
Prevalence of osteoporosis and osteopenia diagnosed using quantitative CT in 296 consecutive lumbar fusion patients
复制标题
296例连续腰椎融合患者中使用定量CT诊断的骨质疏松和骨量减少的患病率
DOI：
10.3171/2020.5.focus20241
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发表时间：
2020-08-01
影响因子：
4.1
通讯作者：
Hughes, Alexander P.
中科院分区：
文献类型：
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作者：
Carlson, Brandon B.;Salzmann, Stephan N.;Hughes, Alexander P.
目的骨质疏松症是一种代谢性骨疾病，增加了脆性骨折的风险。筛查和诊断可以通过测量骨矿物质密度（BMD）使用定量CT断层扫描（QCT）在腰椎。基于美国放射学会（ACR）阈值，QCT衍生的BMD测量可用于诊断骨量减少或骨质疏松症。关于无症状和疾病特异性人群中的疾病患病率存在许多报告;然而，未报告无骨折腰椎融合患者的骨质疏松/骨量减少患病率。本研究的目的是确定骨质疏松症和骨量减少的患病率在腰椎融合患者使用QCT。所有接受腰椎融合术且术前接受精细切割CT扫描的患者均合格。在L1和L2进行QCT衍生的BMD测量。根据ACR标准，L1-2平均BMD用于将患者分类为正常结果、骨质减少或骨质疏松症。计算疾病患病率。根据年龄、性别、种族和BMD异常史进行亚组分析。分类组之间的差异进行了计算与Fisher精确test.Results总体上，296例连续患者（55.4%女性）进行了研究。平均年龄为63岁（范围21-89岁）。有248例（83.8%）患者年龄≥ 50岁。212例（71.6%）患者既往无BMD异常的临床病史。129名（43.6%）患者出现骨质疏松症，44名（14.9%）患者出现骨质疏松症。性别或种族之间的患病率没有差异。年龄>= 50岁的患者骨质减少/骨质疏松的发生率明显高于年龄< 50岁的患者。结论：在296例接受腰椎融合手术的连续患者中，骨质疏松的患病率为14.9%，骨质减少的患病率为43.6%。这是第一份关于QCT诊断无椎体脆性骨折的腰椎融合患者中骨质疏松症患病率的报告。
OBJECTIVE Osteoporosis is a metabolic bone disease that increases the risk for fragility fractures. Screening and diagnosis can be achieved by measuring bone mineral density (BMD) using quantitative CT tomography (QCT) in the lumbar spine. QCT-derived BMD measurements can be used to diagnose osteopenia or osteoporosis based on American College of Radiology (ACR) thresholds. Many reports exist regarding the disease prevalence in asymptomatic and disease-specific populations; however, osteoporosis/osteopenia prevalence rates in lumbar spine fusion patients without fracture have not been reported. The purpose of this study was to define osteoporosis and osteopenia prevalence in lumbar fusion patients using QCT.METHODS A retrospective review of prospective data was performed. All patients undergoing lumbar fusion surgery who had preoperative fine-cut CT scans were eligible. QCT-derived BMD measurements were performed at L1 and L2. The L1-2 average BMD was used to classify patients as having normal findings, osteopenia, or osteoporosis based on ACR criteria. Disease prevalence was calculated. Subgroup analyses based on age, sex, ethnicity, and history of abnormal BMD were performed. Differences between categorical groups were calculated with Fisher's exact test.RESULTS Overall, 296 consecutive patients (55.4% female) were studied. The mean age was 63 years (range 21-89 years). There were 248 (83.8%) patients with ages >= 50 years. No previous clinical history of abnormal BMD was seen in 212 (71.6%) patients. Osteopenia was present in 129 (43.6%) patients and osteoporosis in 44 (14.9%). There were no prevalence differences between sex or race. Patients >= 50 years of age had a significantly higher frequency of osteopenia/osteoporosis than those who were < 50 years of age.CONCLUSIONS In 296 consecutive patients undergoing lumbar fusion surgery, the prevalence of osteoporosis was 14.9% and that for osteopenia was 43.6% diagnosed by QCT. This is the first report of osteoporosis disease prevalence in lumbar fusion patients without vertebral fragility fractures diagnosed by QCT.