Bone mineral density and spongiosa architecture in correlation to vertebral body insufficiency fractures

Andresen, Reimer; Radmer, Sebastian; Banzer, D.

doi:10.1080/02841859809172221

Cited by 21 publications

(14 citation statements)

References 11 publications

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“…All patients were suffering from clinically manifest osteoporosis, with so low values for bone mineral content of the axial skeleton that fractures were totally inevitable [41]. Because of the marked vitamin D deficiency, some patients were probably also suffering from osteomalacia, i.e.…”

Section: Discussionmentioning

confidence: 99%

Clinical Improvement and Cost-effectiveness of CT-guided Radiofrequency Sacroplasty (RFS) and Cement Sacroplasty (CSP) – a Prospective Randomised Comparison of Methods

Andresen¹,

Radmer

Andresen

et al. 2019

Z Orthop Unfall

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Introduction The objective of this study was a comparative analysis of cement augmentation by means of RFS and CSP with regard to outcome and cost-effectiveness. Patients and Methods CT-guided cement augmentation was performed on 100 patients with a total of 168 non-dislocated insufficiency fractures, 50 patients being treated with RFS and 50 patients with CSP. Leakages were detected by CT. Pain intensity was determined on a VAS before and after the intervention. The patientsʼ self-sufficiency was assessed using the Barthel index. Patients were asked about any complications and their level of satisfaction. Costs incurred for carrying out the procedure were compared with the respective reimbursements received. Results Both procedures were technically fully feasible. No leakages were found in the RFS group, as opposed to 8.1% asymptomatic leakages in the CSP group. The mean value for pain before intervention was 8.8 in the RFS group and 8.7 in the CSP group. On the second postoperative day, there was a significant pain reduction with a value of 2.4 for both groups, which remained more or less constant over the follow-up period. The Barthel index increased significantly from an average of 30 before the intervention to 80 on the fourth postoperative day and 70 after 24 months. No differences were found between the two procedures with regard to pain, improvement in functional status and satisfaction. Taking into account the state-wide base rate used for calculating reimbursement, 3,834.75 € remained for RFS and 5,084.32 € for CSP. Conclusion RFS and CSP are minimally invasive procedures that achieve equally good and sustained pain reduction, leading to markedly improved self-sufficiency of the patients. With regard to possible cement leakages, RFS is the safer method. A profit can be generated with both techniques.

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Section: Discussionmentioning

confidence: 99%

Clinical Improvement and Cost-effectiveness of CT-guided Radiofrequency Sacroplasty (RFS) and Cement Sacroplasty (CSP) – a Prospective Randomised Comparison of Methods

Andresen¹,

Radmer

Andresen

et al. 2019

Z Orthop Unfall

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“…The mean bone mineral density of the 10 spines, measured at the lumbar vertebrae 1 to 3, was 54.5±20.0 mg/cm 3 (range, 24.2-87.5), which indicates apronounced osteoporosis (values below 80 mg/cm 3 are considered to be a sign of osteoporosis, values below 60 mg/cm 3 reflect a higher risk of fractures) [16,17]. Table 1 summarizes additional data on the numbers and shapes of vertebral fractures based on the registered vertebral deformities.…”

Section: Quantitative Computed Tomographymentioning

confidence: 99%

A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors

et al. 2021

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The vertebral trabecular bone has a complex three-dimensional microstructure with an inhomogeneous morphology. Correct identification and assessment of the weakest segments of the cancellous bone may lead to better prediction of fracture risk. The aim of this study was to compare cancellous bone from 240 vertebrae of the cervical, thoracic and lumbar spine of ten body donors with osteoporosis in regard to bone volume fraction (BVF), trabecular thickness, separation, trabecular number and degree of anisotropy, to ascertain why cervical vertebrae rarely fracture, even with severe osteoporosis. Samples were obtained from all vertebrae with a Jamshidi needle (8 Gauge). The investigations were performed with a micro-computed tomography (micro-CT) device (SKYSCAN 1172, RJL Micro & Analytic GmbH, Karlsdorf-Neuthard, Germany). Existing vertebral fractures and the bone mineral density of the lumbar spine were assessed with quantitative CT. Regarding the micro-CT parameters, statistically significant differences were observed between the various sections of the spine. We found a higher BVF, trabecular number and trabecular thickness, as well as a lower trabecular separation of the cervical vertebrae compared to other vertebrae. In addition, the degree of anisotropy in the cervical spine is lower than in the other spinal column sections. These results are age and sex dependent. Thus, the cervical spine has special structural features, whose causes must be determined in further investigations.

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“…2 Lumbaler Knochenmineralgehalt (KMG in mg/ml) bezogen auf die Anzahl der Frakturen. Dabei ist ein KMG von unter 80 mg/ml definiert als Osteoporose [13], bei Werten unter 60 mg/ ml steigt das Frakturrisiko signifikant [14]. Deutlich reduzierter KMG führt zu erhöhter Frakturanzahl im thorakalen Bereich sowie im thorakolumbalen Übergang und lumbal.…”

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Warum sich in der Halswirbelsäule auch bei Osteoporose nur selten Insuffizienzfrakturen finden

Schröder¹,

Hiepe

Moritz³

et al. 2021

Z Orthop Unfall

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Zusammenfassung Einleitung Mit zunehmendem Alter verändert sich die Struktur des Knochens. Für seine Festigkeit sind sowohl Material- als auch Struktureigenschaften von Bedeutung. Trotz des Alterns der Gesellschaft liegen jedoch zu diesen Parametern für Menschen im Greisenalter kaum Daten vor. Deshalb werden im Rahmen der vorliegenden Arbeit Spongiosazylinder von Halswirbelkörper III bis Lendenwirbelkörper V aus den jeweiligen Zentren der Wirbelkörper im Hinblick auf Knochenvolumenanteil, Trabekeldicke, Separation, Anzahl der Trabekeln, Quervernetzung, Verbindungsdichte und Grad der Anisotropie untersucht. Material und Methoden Mittels einer Jamshidi-Nadel wurden aus 440 Kadaverwirbeln Proben gewonnen und unter Einsatz der Mikrocomputertomografie analysiert. Bestehende Deformitäten, Frakturen und der Knochenmineralgehalt jedes Wirbels wurden in der quantitativen Computertomografie erfasst. Ergebnisse Hinsichtlich der Mikrocomputertomografie-Parameter zeigten sich statistisch signifikante Unterschiede zwischen den verschiedenen Abschnitten der Wirbelsäule: Die Trabekeln der Halswirbelsäule waren signifikant dicker und standen dichter beisammen als in der Brust- und der Lendenwirbelsäule. Der Knochenvolumenanteil war wie die Verbindungsdichte sowie die Anzahl der Trabekeln und der Quervernetzungen in diesem Wirbelsäulenabschnitt signifikant höher. Darüber hinaus fiel der Grad der Anisotropie in der Halswirbelsäule signifikant geringer aus als in den anderen Wirbelsäulenabschnitten. Bezüglich der quantitativen Computertomografie ergab sich in den Halswirbeln ein signifikant höherer Knochenmineralgehalt. Schlussfolgerung Auch bei vorliegender Osteoporose brechen Halswirbelkörper aufgrund ihrer einzigartigen Mikroarchitektur und höheren Dichte deutlich später als Brust- und Lendenwirbelkörper, eine Spezifität der Halswirbelsäule ist somit gegeben.

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Bone mineral density and spongiosa architecture in correlation to vertebral body insufficiency fractures

Abstract: sQCT provides a good risk assessment of the occurrence of vertebral body insufficiency fractures.

Cited by 21 publications

References 11 publications

Clinical Improvement and Cost-effectiveness of CT-guided Radiofrequency Sacroplasty (RFS) and Cement Sacroplasty (CSP) – a Prospective Randomised Comparison of Methods

Clinical Improvement and Cost-effectiveness of CT-guided Radiofrequency Sacroplasty (RFS) and Cement Sacroplasty (CSP) – a Prospective Randomised Comparison of Methods

A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors

Warum sich in der Halswirbelsäule auch bei Osteoporose nur selten Insuffizienzfrakturen finden

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