Journal of Hebei Medical University ›› 2023, Vol. 44 ›› Issue (3): 274-278.doi: 10.3969/j.issn.1007-3205.2023.03.006

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Prediction of preoperative vertebral compression degree combined with bone mineral density in re-loss of vertebral body height after pedicle screw internal fixation for thoracolumbar fractures

  

  1. 1.Department of Orthopedics, Huai′an First Hospital, Nanjing Medical University, Jiangsu Province, 
    Huaian 223000, China; 2.Medical College of Nantong University, Jiangsu Province, Nantong 
    226000, China; 3.Department of Orthopedics, Nanjing First Hospital, Nanjing 
    Medical University, Jinagsu Province, Nanjing 210000, China
  • Online:2023-03-25 Published:2023-03-24

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Abstract: Objective To investigate the predictive value of preoperative vertebral compression degree combined with bone mineral density in the re-loss of vertebral body height after pedicle screw internal fixation for thoracolumbar fractures. 
Methods To investigate the predictive value of preoperative vertebral compression degree combined with bone mineral density in the re-loss of vertebral body height after pedicle screw internal fixation for thoracolumbar fractures. 
Results By the end of follow-up, the incidence of vertebral body height re-loss was 36.05%. The loss group had higher intraoperative screw insertion, early postoperative weight-bearing ratio, and preoperative vertebral body compression than the non-loss group (P＜0.05), and preoperative bone mineral density was lower than that of the non-loss group (P＜0.05). Logistic regression analysis showed that multiple intraoperative screw insertions (OR=2.869, 95%CI: 1.045-4.183), early postoperative weight-bearing (OR=2.956, 95%CI: 1.632-5.279), preoperative vertebral compression degree (OR=3.615, 95%CI: 2.873-9.418) and preoperative bone mineral density (OR=3.284, 95%CI: 2.084-7.436) were risk factors affecting the re-loss of vertebral body height after pedicle screw internal fixation for thoracolumbar fractures (P＜0.05). The results of ROC curve analysis showed that the preoperative vertebral compression degree, bone mineral density, and their combination for predicting the re-loss of vertebral body height after pedicle screw internal fixation had the sensitivity of 70.97% (95%CI: 51.76%-85.11%), 74.19% (95%CI: 55.07%-87.46%), and 70.97% (95%CI: 51.76%-85.11%) ,respectively, the specificity of 76.36% (95%CI: 62.67%-86.35%), 72.73% (95%CI: 58.81%-83.46%), and 93.36% (95%CI: 86.39%-99.37%), respectively, and AUC of 0.706 (95%CI: 0.598-0.801), 0.757 (95%CI: 0.653-0.841), and 0.883 (95%CI: 0.793-0.945), respectively. 
Conclusion The combination of preoperative vertebral compression degree and bone mineral density has a higher predictive value for re-loss of vertebral body height after thoracolumbar fractures.


Key words: spinal fractures, fracture fixation, internal, bone density