Гений oртопедии (Oct 2022)
Bone mineral density of lumbar vertebrae in patients with degenerative spinal diseases
Abstract
of BMD in Hounsfield units (HU) according to CT data is a more accurate method versus to the "gold" standard – densitometry. Purpose To determine BMD of key anatomical areas of the lumbar vertebrae in HU and correlate with densitometry data. Methods A retrospective cohort of patients was studied prior to decompression and stabilization intervention at the lumbar level. The BMD of each lumbar vertebra in its different anatomical regions in HU was assessed according to CT of the lumbar spine and was compared with densitometry data. Results In the roots of the L2-S1 arch of the vertebrae, BMD was significantly higher than in the bodies of the same vertebrae (p < 0.01); in the L1 and S1 vertebrae, the difference in BMD between the body and the roots of the arch was not significant. An increase in the density of bone tissue in the vertebral bodies to the underlying levels was determined; BMD in the roots of the arch also increases, but only up to the L5 vertebra. BMD in the roots of the arch of the S1 vertebra is significantly lower than in the overlying L5 vertebra (p = 0.032). Discussion The obtained findings supplement the reported data in the current literature. The HU value is a more accurate and significant parameter of BMD, which should be considered in the practice by a spinal surgeon. Conclusions According to CT data of the lumbar spine, the BMD of L2-L5 in the arch roots is significantly higher than in the vertebral bodies. The BMD of the S1 vertebra in the arch roots is significantly lower than in the L5 vertebra. It may be the reason of high failure rate of caudal fixation at this level. Particular attention should be paid to the planning and surgical techniques in patients not only with osteoporosis but also with osteopenia. BMD findings obtained by densitometry in these conditions do not have a significant difference.
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