| Objective It provides a theoretical basis for the clinical application of cortical bone screw technology in patients with osteoporosis,Comparing the average CT value of the bone around the screw path of lumbar CBT screw in different directions.Methods Screening of osteoporosis patients admitted to the Department of Spinal Orthopedics of Ningxia Medical University General Hospital from June 2016 to December2020(Bone mineral density T value ≤-2.5;Dual energy X-ray absorption method)100 male and 100 female patients,the high resolution in patients with lumbar spinal CT scan image data import Mimics17.0,through to the L4 vertebral reconstruction after processing,the construction of the cylinder(35 mm in length,5.5 mm in diameter)to simulate the CBT screw nailing from five different directions: traditional placement,vertical placement and three different sagittal direction(caudal,parallel,cranial)placement;The mean CT values of the intersecting area with bone were measured in different orientation of the implant.Results1.The mean CT value around the screw path in male osteoporosis patients were(198.74±26.10)HU,(301.94±43.67)HU,(375.41±40.76)HU,(374.24±45.37)HU,and(453.94±50.78)HU,respectively,in the direction of conventional cortical screw placement,vertical screw placement,parallel screw placement,caudal screw placement,and cranial screw placement.Compared with the traditional orientation,the average CT value of the vertical orientation of the screw path increased by 52.02%,the average CT value of the parallel orientation of the screw path increased by 88.90%,the average CT value of the caudal orientation of the screw path increased by 88.30%,the average CT value of the cranial orientation of the screw path increased by 128.41%,the average CT value of the cranial orientation of the screw path increased the most.In male patients with osteoporosis L4 vertebral body in different direction nailed around the average CT value of statistical analysis,the traditional placement direction and the remaining four nail placement direction around the average CT value comparison were statistically significant(P < 0.01),parallel nail placement direction and vertical placement direction way around the average CT value is no statistical significance(P > 0.05);2.The mean CT values around the screw path of female osteoporosis patients were(199.13±27.35)HU,(294.43±44.45)HU,(367.51±41.59)HU,(368.05±45.18)HU,and(446.59±48.71)HU,respectively,in the direction of conventional cortical screw placement,vertical screw placement,parallel screw placement,caudal screw placement,and cranial screw placement.Compared with the traditional orientation,the average CT value of the vertical orientation of the screw path increased by 47.86%,the average CT value of the parallel orientation of the screw path increased by 84.56%,the average CT value of the caudal orientation of the screw path increased by 84.82%,the average CT value of the cranial orientation of the screw path increased by 124.27%,the average CT value of the cranial orientation of the screw path increased by the most.In female with osteoporosis L4 vertebral body in different direction nailed around the average CT value of statistical analysis,the traditional placement direction and the remaining four nail placement direction around the average CT value comparison were statistically significant(P < 0.01),parallel nail placement direction and vertical placement direction way around the average CT value is no statistical significance(P > 0.05);3.In all patients,the mean CT values around the screw path were(198.93±26.66)HU,(298.22±44.11)HU,(373.34±41.26)HU,(371.19±45.27)HU and(450.30±49.78)HU,respectively,in the direction of conventional cortical screw placement,vertical screw placement,parallel screw placement,caudal screw placement and cranial screw placement.Compared with the traditional direction,the average CT value of the screw path in the vertical direction increased by 49.91%,that in the parallel direction increased by 87.67%,that in the caudal direction increased by 86.59%,that in the cranial direction increased by126.36%,and that in the cranial direction increased by the most.There were statistical differences in the average CT values around the screw path between the traditional and the other four directions(P < 0.01),while there was no statistical significance in the average CT values around the screw path between the parallel and vertical directions(P value > 0.05).4.By means of single men and single women or all of the patients with different nail placement direction around the average CT value of statistical analysis,the traditional placement direction compared with the rest of the four kinds of placement direction were statistically significant(P values < 0.01),parallel nail placement direction and vertical placement direction way around the average CT value is no statistical significance(P >0.05);By pairwise comparison of the mean CT values of bone around the screw path in the same direction among the three groups,the results showed no statistical difference(P value >0.05).Conclusion By measuring and analyzing the average CT value of the bone around the screw path of lumbar CBT screws in different directions,it was found that the average CT value of the screw path in the anterior direction was the highest,which provided a theoretical basis for the clinical application of cortical bone screw technology in patients with osteoporosis. |
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