„Hounsfield units“ als Maß für die Knochendichte – Anwendungsmöglichkeiten in der Wirbelsäulenchirurgie

Scheyerer, Max J.; Ullrich, Bernhard; Osterhoff, Georg; Spiegl, U; Schnake, Klaus John

doi:10.1007/s00113-019-0658-0

Cited by 30 publications

(18 citation statements)

References 53 publications

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“…Recent studies suggest measurements of three different vertebrae, however. Furthermore, there is an ongoing scientific debate on the exact cutoff values for the differentiation between healthy, impaired and osteoporotic bone stock [41]. Data previously published by these authors, indicate that a 150 HU's seem to be a valid cut-off value for the differentiation between healthy and impaired bone quality [23].…”

Section: Discussionmentioning

confidence: 99%

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

Hartel

Naji

Fensky

et al. 2021

Arch Orthop Trauma Surg

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Purpose To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. Patients and methods A consecutive case series of 50 acetabular fractures (patient age 69 ± 23 years) treated with suprapectineal anatomic plates were analyzed in a retrospective study. The analysis included: Mechanism of injury, fracture pattern, surgical approach, need for additional total hip arthroplasty, intra- or postoperative complications, as well as bone mass density and radiological outcome on postoperative computed tomography. Results Most frequently, anterior column fracture patterns with and without hemitransverse components as well as associated two column fractures were encountered. The anterior intrapelvic approach (AIP) was used in 98% (49/50) of the cases as primary approach with additional utilization of the first window of the ilioinguinal approach in 13/50 cases (26%). Determination of bone density revealed impaired bone quality in 70% (31/44). Postoperative steps and gaps were significantly greater in this subgroup (p < 0.05). Fracture reduction quality for postoperative steps revealed anatomic results in 92% if the bone quality was normal and in 46% if impaired (p < 0.05). In seven cases (14%), the plate was utilized in combination with acute primary arthroplasty. Conclusion A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.

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Section: Discussionmentioning

confidence: 99%

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

Hartel

Naji

Fensky

et al. 2021

Arch Orthop Trauma Surg

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“…In contrast, Choi et al defined ≤ 100 HUs as osteoporotic and Pickard et al, as well as Lee et al, defined ≤ 110 HUs as the threshold to characterize osteoporosis [9,10,16]. In a recent review article, Scheyerer et al focus on the value of the Hounsfield units as a measure of bone density and the possible applications in spinal surgery [17]. They emphasize on the measurement in clinical routine CT scans to early diagnose and treat osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, this method also has disadvantages, there is no standardization and the values are device-specific. Furthermore, the authors recommend three measurements within each vertebra (cranial, middle, caudal) and at least the evaluation of three vertebra [17]. Thus, this measurement is time consuming and we think routine use will be difficult.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of Traumatic Osteoporotic and Non-Osteoporotic Vertebral AO A3 Fractures by Analyzing the Posterior Edge Morphology—A Retrospective Feasibility Study

Wähnert

Klingebiel

Lohmaier

et al. 2020

JCM

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Background: Differentiation between traumatic osteoporotic and non-osteoporotic vertebral fractures is crucial for optimal therapy planning. We postulated that the morphology of the posterior edge of the cranial fragment of A3 vertebral fractures is different in these entities. Therefore, the purpose of this study is to develop and validate a simple method to differentiate between osteoporotic and non-osteoporotic A3 vertebral fractures by morphological analysis. Methods: A total of 86 computer tomography scans of AO Type A3 (cranial burst) vertebral body fractures (52 non-osteoporotic, 34 osteoporotic) were included in this retrospective study. Posterior edge morphology was analyzed using the sagittal paramedian slice with the most prominent shaped bulging. Later, the degree of bulging of the posterior edge fragment was quantified using a geometric approach. Additionally, the Hounsfield units of the broken vertebral body, the vertebra above, and the vertebra below the fracture were measured. Results: We found significant differences in the extent of bulging comparing osteoporotic and non-osteoporotic fractures in our cohort. Using the presented method, sensitivity was 100%, specificity was 96%. The positive predictive value (PPV) was 94%. In contrast, by evaluating the Hounsfield units, sensitivity was 94%, specificity 94% and the PPV was 91%. Conclusions: Our method of analysis of the bulging of the dorsal edge fragment in traumatic cranial burst fractures cases allows, in our cases, a simple and valid differentiation between osteoporotic and non-osteoporotic fractures. Further validation in a larger sample, including dual-energy X-ray absorptiometry (DXA) measurements, is necessary.

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“…1). Klinische Studien zeigen eine signifikante Korrelation der Hounsfield-Einheiten zu T-Werten der DXA-Messung [7]. Aus den Hounsfield-Einheiten unterhalb der Deckplatte, mittig im Wirbelkörper und oberhalb der Grundplatte wird der Durchschnittswert erhoben.…”

Section: Osteoporoseunclassified

“…Aus den Hounsfield-Einheiten unterhalb der Deckplatte, mittig im Wirbelkörper und oberhalb der Grundplatte wird der Durchschnittswert erhoben. Bei Werten < 110 gilt eine Osteoporose als wahrscheinlich, bei > 160 als ausgeschlossen [7].…”

Section: Osteoporoseunclassified

Vertebro- und Kyphoplastie

Thomé¹,

Vetter²

2021

Orthopädie und Unfallchirurgie up2date

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ZusammenfassungDie Vertebroplastie und die Kyphoplastie sind minimalinvasive, perkutane Augmentationsverfahren. Sie werden meist bei schmerzhaften osteoporotischen Wirbelkörperkompressionsfrakturen des älteren Menschen eingesetzt. Durch den demografischen Wandel ist mit einem ansteigenden Versorgungsbedarf zu rechnen. In diesem Beitrag werden Indikationen, technische Prinzipien und mögliche Komplikationen beider Verfahren beleuchtet und die aktuelle Literatur dargestellt.

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„Hounsfield units“ als Maß für die Knochendichte – Anwendungsmöglichkeiten in der Wirbelsäulenchirurgie

Cited by 30 publications

References 53 publications

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

Differentiation of Traumatic Osteoporotic and Non-Osteoporotic Vertebral AO A3 Fractures by Analyzing the Posterior Edge Morphology—A Retrospective Feasibility Study

Vertebro- und Kyphoplastie

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