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European Spine Journal

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01-05-2020 | Computed Tomography | Original Article

Characteristics of vertebral CT Hounsfield units in elderly patients with acute vertebral fragility fractures

Authors: Da Zou, Kaifeng Ye, Yun Tian, Weishi Li, Fang Zhou, Zhishan Zhang, Zhengyang Lu, Zhongning Xu

Published in: European Spine Journal | Issue 5/2020

Abstract

Objective

To explore the characteristics of vertebral CT Hounsfield units (HU) in elderly patients with acute vertebral fragility fractures.

Methods

A total of 299 patients aged ≥ 65 years with acute vertebral fragility fractures were retrospectively reviewed, and 77 patients of them were age- and sex-matched with 77 control patients without any fractures. The vertebral HU value of L1(L1-HU) was measured, and T12 and L2 were used as alternatives for L1 in the case of L1 fracture.

Results

There were 460 thoracic and lumbar vertebral fractures in the 299 elderly patients, including 349 acute vertebral fragility fractures and 111 chronic fractures. The average L1-HU value was 66.0 ± 30.6 HU and showed significant difference among patients having different numbers of vertebral fractures (one fracture: 73.3 ± 27.0 HU, two fractures: 58.7 ± 32.5 HU, three or more fractures: 40.7 ± 28.8 HU; P < 0.001). As for the 1:1 age- and sex-matched patients, the L1-HU of the 77 patients with fractures was lower than that of the control patients (70.6 ± 23.4 HU vs. 101.5 ± 36.2 HU, P < 0.001). The area under the receiver operating characteristic curve of using L1-HU to differentiate patients with fractures from controls was 0.77(95% CI 0.70–0.85, P < 0.001). The cutoff value had high specificity of 90% or high sensitivity of 90% to identify patients with fractures of 60 HU and 100 HU, respectively.

Conclusions

The elderly patients with acute vertebral fragility fractures have much lower HU values than those without fractures. Moreover, the lower the vertebral HU value is, the more likely the patients have more than one vertebral fracture.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Characteristics of vertebral CT Hounsfield units in elderly patients with acute vertebral fragility fractures
Authors: Da Zou
Kaifeng Ye
Yun Tian
Weishi Li
Fang Zhou
Zhishan Zhang
Zhengyang Lu
Zhongning Xu
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Osteoporosis
Osteoporosis
Published in: European Spine Journal / Issue 5/2020
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-020-06363-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Characteristics of vertebral CT Hounsfield units in elderly patients with acute vertebral fragility fractures

Abstract

Objective

Methods

Results

Conclusions

Graphic abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Graphic abstract

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