A modification and validation of quantitative morphometry classification system for osteoporotic vertebral compressive fractures in mainland Chinese

• Published in: Osteoporosis international Vol. 29; no. 11; pp. 2495 - 2504
• Main Authors: Song, L.-J., Wang, L.-L., Ning, L., Fan, S.-W., Zhao, X., Chen, Y.-L., Li, Z.-Z., Hu, Z.-A.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.11.2018; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Bone Cements; Cement; Classification; Compression; Endocrinology; Extravasation of Diagnostic and Therapeutic Materials - diagnostic imaging; Extravasation of Diagnostic and Therapeutic Materials - pathology; Female; Fractures; Fractures, Compression - diagnostic imaging; Fractures, Compression - pathology; Fractures, Compression - surgery; Humans; Kyphoplasty - methods; Leakage; Male; Medicine; Medicine & Public Health; Middle Aged; Morphometry; Original Article; Orthopedics; Osteoporosis; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - pathology; Osteoporotic Fractures - surgery; Postoperative Complications - diagnostic imaging; Postoperative Complications - pathology; Postoperative Period; Radiographic Image Interpretation, Computer-Assisted - methods; Radiography; Reproducibility of Results; Retrospective Studies; Rheumatology; Spinal Fractures - diagnostic imaging; Spinal Fractures - pathology; Spinal Fractures - surgery; Spine; Vertebrae; Cement leakage; Osteoporotic vertebral compression fracture; Vertebral height ratio restoration; Modified quantitative morphometry system
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-018-4641-3

Summary This study described a modified quantitative morphometry (mQM) system adapted to specific reference values for Mainland Chinese population. The mQM system is validated using the Genant Semiquantative system and is sensitive for detecting vertebral height changes and predicting cement leakage after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compressive fracture (OVCF). Introduction OVCF is a manifestation of osteoporosis. To improve clinical management of osteoporosis, the quantitative morphometry (QM) system has been widely used for the early diagnosis and precise classification of OVCF in developed countries. Here, we present an mQM system and validated its use in detecting OVCF in Mainland Chinese. Methods Using our mQM system, the pre- and post-operative values of vertebral heights were measured and evaluated in 309 Mainland Chinese who received percutaneous kyphoplasty (PKP) as OVCF treatment. Measurements and classification of fractures from the mQM system were validated by comparing to values obtained by the Genant semiquantative (SQ) method. Moreover, we evaluated the sensitivity of the mQM system by its ability to detect restoration of vertebral heights and predict cement leakage after PKP. Results The five classification of fractures, No deformity (ND), anterior wedge (AW), posterior wedge (PW), biconcavity (BC), and compression (CP), evaluated by the mQM method shared similar distribution characteristics compared to those obtained by the SQ method. In addition, mQM evaluation showed that the vertebra height of all fracture types showed significant restoration after PKP. The incidence of cement leakage was most common in CP (37.5%), followed by AW (31.6%), BC (26.5%), ND (23.7%), and PW (0.0%). Conclusions Our mQM system is suitable for classification of fractures, detection of vertebral height restoration, and correlation of cement leakage after PKP in Mainland Chinese population.