Volumetric analysis of thoracic and lumbar vertebral bodies
Volumetric analysis of thoracic and lumbar vertebral bodies
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DOI：
10.1016/j.spinee.2009.11.018
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发表时间：
2010-02-01
期刊：
影响因子：
4.5
通讯作者：
Markovic, Alexander
中科院分区：
文献类型：
--
作者：
Limthongkul, Worawat;Karaikovic, Eldin E.;Markovic, Alexander
背景情况：在过去的十年中，骨水泥椎体增强技术（椎体后凸成形术和椎体成形术）显示，75%至100%的椎体压缩性骨折患者术后疼痛缓解良好至中度，椎体高度充分恢复。在不同的报告中，注入椎骨的骨水泥体积各不相同。据我们所知，目前还没有关于胸腰椎椎体体积的生理分布的研究报道。目的：本研究的目的是定量评估胸腰椎椎体体积。研究设计/设置：40例胸腰椎的计算机断层扫描（CT）扫描被用来测量每个椎体的体积。方法：使用BrainLAB软件（iPlan RT image 4.0）程序分析了40例胸椎和腰椎（20例男性和20例女性）标准2.5 mm骨窗切割的CT扫描，以测量椎体的容积。该软件进行了测试的有效性和可靠性在两个试点研究。计算并记录每个椎体体积的平均值和标准差。椎体的工作距离和所谓的“安全区”也进行了测量，以确定一个尺寸的球囊用于椎体后凸plasty.Results：椎体体积逐渐增加，从T1到L4的例外L5，测得小于L4。平均胸椎体积为15.0 cm（3）（绝对值范围为5.2 - 39.5 cm（3）），平均腰椎体积为35 cm（3）（绝对值范围为19.7 - 61.5 cm（3））。与女性相比，男性仅在腰椎中具有较大的椎体体积。T1至T4的平均椎体工作距离为23.4 +/- 2.7 mm，T5至T9为30.3 +/- 3.6 mm，T10至L5为35.5 +/- 3.9 mm。了解椎体体积的生理变异性有助于预防由于在手术过程中骨水泥量过多或骨水泥不足而导致的并发症。椎体后凸成形术或椎体成形术。我们建议在椎体后凸成形术中，从T1到T4使用10 mm球囊，从T5到T9使用15 mm球囊，从T10到L5使用20 mm球囊。(C)2010年爱思唯尔公司All rights reserved.
BACKGROUND CONTEXT: During the last decade, vertebral augmentation techniques with cement (kyphoplasty and vertebroplasty) have revealed that 75% to 100% of individuals with osteoporotic vertebral compression fractures have good to moderate pain relief postoperatively, as well as adequate restoration of the vertebral body height. The volume of cement injected into a vertebra varied in different reports. To our knowledge, there are no studies that report on the physiological distribution of thoracic and lumbar vertebrae body volumes.PURPOSE: The purpose of this study was to quantitatively evaluate thoracic and lumbar vertebral body volumes.STUDY DESIGN/SETTING: Forty computed tomography (CT) scans of the thoracic and lumbar spines were used to measure a volume of each vertebral body.METHODS: Forty CT scans with standard 2.5-mm bone window cuts of the thoracic and lumbar vertebrae (20 men and 20 women) were analyzed to measure the volumetric capacity of vertebral bodies using a BrainLAB Software (iPlan RT image 4.0) program. The software was tested for validity and reliability in two pilot studies. Mean and standard deviations for each vertebral body volume were calculated and recorded. The vertebral body working distance and the so-called "safe zone" were also measured to determine a size of a balloon to be used in kyphoplasty.RESULTS: Vertebral body volume increased gradually from T1 to L4 with the exception of L5, which measured to be smaller than L4. The mean thoracic vertebrae volume was 15.0 cm(3) (ranged in the absolute values from 5.2 to 39.5 cm(3)), and the mean lumbar vertebrae volume was 35 cm(3) (ranged in the absolute values from 19.7 to 61.5 cm(3)). Men had larger volume vertebral bodies only in the lumbar spine compared with women. The average vertebral body working distances from T1 to T4 was 23.4 +/- 2.7 mm, from T5 to T9 was 30.3 +/- 3.6 mm, and from T10 to L5 was 35.5 +/- 3.9 mm.CONCLUSIONS: Knowing the physiological variability of vertebral body volumes may help prevent complications as a result of underaugmentation or overaugmentation with excessive amount of cement during kyphoplasty or vertebroplasty in osteoporotic compression fractures. We recommend using 10 mm balloons from T1 to T4, 15 mm balloons from T5 to T9, and 20 mm balloons from T10 to L5 for kyphoplasty. (C) 2010 Elsevier Inc. All rights reserved.