Application Of Quantitative Morhpometry In The Evaluation Of Osteoporotic Fracture Of Spine

Objective:To compare the consistency between the three-line method(quantitative morphometry)and the Genant semi-quantitative method in the assessment of vertebral osteoporotic fractures,and analysis of factors associated with osteoporotic fractures.Methods:In this study,we selected 96 patients who underwent thoracolumbar spine X-ray examination and dual-energy X-ray absorptiometry at the ningbo first hospital from January 2018 to January2020 as the study subjects.The age and body mass index(BMI)of all study subjects were recorded,and a total of eight vertebral bodies from the tenth thoracic vertebra to the fifth lumbar vertebra(T10-L5)in the thoracolumbar spine radiographs of the study subjects were assessed using the three-line method and the Genant semi-quantitative method,respectively — the three-line method provided by the authors for the assessment of vertebral fractures;the Genant semi-quantitative method is currently the most commonly used method for the assessment of vertebral fractures.The diagnosis of osteoporosis was based on the diagnostic criteria for osteoporosis proposed by the World Health Organization.Results:1.There were 55 patients diagnosed with vertebral fracture by three-line method.The total of the vertebral fracture segment was 84.And there were 6 patients aged 50～59 years old with 13 vertebral fracture segments,And there were 21 patients aged 60～69 years old with 31 vertebral fracture segments.And there were 28 patients aged > 70 years old with 40 vertebral fracture segments.There were 47 patients diagnosed with vertebral fracture by Genant semi quantitative method.The total of the vertebral fracture segment was 60.And there were 6,19 and 22 patients with 10,23 and 27 vertebral fracture segments in above three age groups.The consistency between the three-line method and the Genant semi-quantitative method in the evaluation of the presence and degree of vertebral fractures at every ages is acceptable(k > 0.4).2.Vertebral fractures occur frequently in T11-L2.3.The correlation between bone mineral density T value and BMI was statistically significant(P < 0.05),but there was no significant difference with age(P > 0.05).4.There was no significant difference in age,BMI,lumbar spine bone mineral density T value,and femoral neck bone mineral density T value between those with vertebral fractures and those without vertebral fractures diagnosed by the three-line method(P > 0.05).There was also no statistically significant difference in age,BMI,lumbar spine bone mineral density T value,and femoral neck bone mineral density T value between those with vertebral fractures and those without vertebral fractures diagnosed by Genant semi-quantitative method(P> 0.05).5.There was no significant difference in age,BMI,lumbar spine bone mineral density T value,and femoral neck bone mineral density T value between patients with vertebral fractures diagnosed by three-line method and those diagnosed by Genant semi-quantitative method(P > 0.05).There was also no statistically significant difference in age,BMI,lumbar spine bone mineral density T value,and femoral neck bone mineral density T value between patients with non-vertebral fractures diagnosed by these two methods.(P > 0.05).Conclusion:1.Both the three-line method and Genant semi-quantitative method are effective methods for evaluating osteoporotic vertebral fractures,and the three-line method is more sensitive than the Genant semi-quantitative method,especially in the diagnosis of mild-to-moderate compression fractures.2.Vertebral fractures occur frequently in T11-L2.3.Bone mineral density is associated with BMI,and low BMI can lead to low bone mineral density.4.For patients over 50 years of age who actively visit the doctor,age cannot be used as an indicator to predict the level of bone mineral density values.5.Patients with suspected osteoporosis should undergo thoracolumbar spine X-ray examination to investigate vertebral osteoporotic fractures.6.It is recommended to assess the presence of vertebral fractures using the three-line method combined with the Genant semi-quantitative method.