Accuracy of spinal curvature assessed by a computer-assisted device and anthropometric indicators in discriminating vertebral fractures among individuals with back pain
Accuracy of spinal curvature assessed by a computer-assisted device and anthropometric indicators in discriminating vertebral fractures among individuals with back pain
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通过计算机辅助设备和人体测量指标评估脊柱曲率的准确性，以区分背痛患者的椎骨骨折
DOI：
10.1007/s00198-014-2680-y
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Aoyagi K
中科院分区：
文献类型：
--
作者：
Mizukami S;Abe Y;Tsujimoto R;Arima K;Kanagae M;Chiba G;Aoyagi K
摘要这项研究检验了胸椎和腰椎后凸角度以及人体测量学指标在50-50岁患有背痛的日本女性中用于区分脊椎骨折患者的准确性。与特定区域的后凸角度和人体测量学指标一起，胸椎和腰椎后凸角度的组合提供了最高的准确性。然而，与脊柱骨折相关的腰椎后凸改变的报道很少。本研究探讨胸椎后凸角、腰椎后凸角测量以及人体测量指标(腰椎后凸角、腰椎后凸角)在脊柱骨折诊断中的准确性。方法对70例因腰背痛就诊的日本绝经后妇女(平均年龄76.2 ± 9.0岁)拍摄脊柱侧位X线片。根据日本标准，采用定量测量的方法诊断椎体骨折。骨关节炎(OA)定义为Kellgren-Lawrence(KL)3级或以上。用SpinalMouse®测量TKA和LKA。结果49例受试者中有49例(70%)存在至少一处椎体骨折。女性椎体骨折患者的LKA、TKA、 + LKA和WOD显著增加，RPD显著降低。Logistic回归分析显示，TKA、 + 、LKA与椎体骨折之间存在显着的相关性，而与骨关节炎的存在无关。受试者操作特性分析显示，TKA有助于鉴别胸椎骨折(AUC，0.730)，LKA有助于腰椎骨折(AUC，0.691)。TKA、 + 、LKA联合检测胸椎、腰椎和任何椎体骨折的准确率最高，AUC分别为0.779、0.728和0.783。WOD和RPD对胸椎、腰椎和任何椎体骨折的准确性为低到中等。结论SpinalMouse®和人体测量学指标对脊柱后凸的评估在鉴别脊柱骨折患者方面是有用的。这些方便和无辐射的方法有助于脊椎骨折的早期诊断和随后的适当治疗，从而防止更多的骨质疏松性骨折。
SummaryThis study examined the accuracy of thoracic and lumbar kyphotic angles as well as anthropometric indicators for discriminating patients with vertebral fracture among Japanese women >50 years old with back pain. Along with region-specific kyphotic angles and anthropometric indicators, the combination of thoracic and lumbar kyphotic angles offered the highest accuracy.IntroductionVertebral fractures have been associated with thoracic kyphosis. However, reports on lumbar kyphotic changes in association with vertebral fracture are scarce. This study investigated the accuracy of thoracic kyphotic angle (TKA) and lumbar kyphotic angle (LKA) measurements as well as anthropometric indicators (wall–occiput distance (WOD) and rib–pelvis distance (RPD)) in discriminating patients with vertebral fracture.MethodsLateral radiographs of the spine were obtained in 70 postmenopausal Japanese women who visited an orthopedic clinic with low back pain (mean age, 76.2 ± 9.0 years). Radiographic vertebral fracture was diagnosed using quantitative measurement according to Japanese criteria. Osteoarthritis (OA) was defined as Kellgren–Lawrence (KL) grade 3 or higher. TKA and LKA were measured using SpinalMouse®. WOD and RPD were also measured.ResultsAt least one vertebral fracture was present in 49 subjects (70 %). Women with vertebral fractures showed significant increases in LKA, TKA + LKA, and WOD and decreases in RPD. Logistic regression analysis showed significant association between TKA + LKA and vertebral fracture independent of the presence of OA. Receiver operating characteristic analysis revealed that TKA was useful for discriminating thoracic fractures (area under the curve (AUC), 0.730) and LKA was useful for lumbar fractures (AUC, 0.691). The combination of TKA + LKA offered the highest accuracy for detecting thoracic, lumbar, and any vertebral fractures, with AUCs of 0.779, 0.728, and 0.783, respectively. WOD and RPD showed low-to-moderate accuracies for thoracic, lumbar, and any vertebral fractures.ConclusionsAssessment of spinal kyphosis by SpinalMouse® as well as anthropometric indicators proved useful in discriminating subjects with vertebral fractures. These convenient and radiation-free methods could contribute to early diagnosis of vertebral fractures and subsequent appropriate treatment, thus preventing additional osteoporotic fractures.
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DOI：
--
发表时间：
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期刊：
BMC Musculoskeletal Disorders 9
影响因子：
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