Quantitative vertebral compression fracture evaluation using a height compass

Abstract

Vertebral compression fractures can be caused by even minor trauma in patients with pathological conditions such as osteoporosis, varying greatly in vertebral body location and compression geometry. The location and morphology of the compression injury can guide decision making for treatment modality (vertebroplasty versus surgical fixation), and can be important for pre-surgical planning. We propose a height compass to evaluate the axial plane spatial distribution of compression injury (anterior, posterior, lateral, and central), and distinguish it from physiologic height variations of normal vertebrae. The method includes four steps: spine segmentation and partition, endplate detection, height compass computation and compression fracture evaluation. A height compass is computed for each vertebra, where the vertebral body is partitioned in the axial plane into 17 cells oriented about concentric rings. In the compass structure, a crown-like geometry is produced by three concentric rings which are divided into 8 equal length arcs by rays which are subtended by 8 common central angles. The radius of each ring increases multiplicatively, with resultant structure of a central node and two concentric surrounding bands of cells, each divided into octants. The height value for each octant is calculated and plotted against octants in neighboring vertebrae. The height compass shows intuitive display of the height distribution and can be used to easily identify the fracture regions. Our technique was evaluated on 8 thoraco-abdominal CT scans of patients with reported compression fractures and showed statistically significant differences in height value at the sites of the fractures.

Vertebral Body Compression Fractures and Bone Density: Automated Detection and Classification on CT Images

“…Additionally, we measured bone density in this study. Our group performed preliminary work in direct determination of height loss in the height compass model, without creation of a Genant model and without Genant categorization or assessment of bone density (35).…”

Detection of Vertebral Body Fractures Based on Cortical Shell Unwrapping

“…Design of algorithms has been performed for simple assessment of anterior height loss of thoracolumbar vertebrae, and has recently reached the stage of clinical application limited to plain film radiograph lateral views of the spine [3]. There are also prior works assessing for fractures based on detected global geometric deformities of the vertebral bodies (compression deformities), rather than direct detection of fracture lines in the vertebrae [4] [5]. Analysis of the complex structure of the spine on cross sectional CT images for direct visualization of fractures is a novel topic of clinical importance, and is the goal and focus of this investigation.…”

Automated Detection, Localization, and Classification of Traumatic Vertebral Body Fractures in the Thoracic and Lumbar Spine at CT

“…Additionally, research has been conducted for computerized assessment of compression fractures through the detection of vertebral body height loss on midline sagittal sections of lumbar computed tomographic (CT) images and on three-dimensional volumetric renderings (22,23). However, simple height measurement is not sufficient for fracture categorization in a number of spine trauma injury classification systems in clinical use.…”