骨粗鬆症性脊椎椎体骨折における予後不良因子の検討

Evaluation of Prognostic Factors for Osteoporotic Vertebral Fractures

　高齢者の骨粗鬆症性椎体骨折後の骨癒合例と偽関節例における受傷機転，骨折高位，画像所見の相違について検討を行った．骨粗鬆症に伴う新鮮椎体骨折例で，44例50椎体を対象とした．性別の内訳は男性12例，女性32例で，受傷時年齢は，平均73.3歳であった．検討項目は，受傷原因，骨折高位，MRIのT1，T2強調矢状断像での輝度変化について行った．偽関節へ移行するものは，外傷機転が明らかでない症例，胸腰椎移行部レベルの骨折例，椎体の後壁損傷例，T1，T2強調矢状断像で広範囲に低輝度変化を示す例が多かった．

　The present study evaluated prognostic factors for osteoporotic vertebral fractures. Forty-four patients, 12 men and 32 women, with 50 osteoporotic vertebral fractures were enrolled in the study. The average patient age at the time of injury was 73.3 years. Bony union was obtained in 38 cases, and pseudarthrosis was observed in 12 cases. In each group, the cause of the fracture, the fracture level, and imaging characteristics(including MR images)were evaluated. In the pseudoarthrosis group, the trauma that induced the fracture tended to be much less severe than that in the bone-union group. The ratio of vertebral collapse was not a factor inducing non-union, but injury of the posterior wall of the body may be a factor causing non-union. Large low-intensity changes both on T1-and T2-weighted images suggesting acute hematoma within the vertebral body may be a predictor of pseudoarthrosis following osteoporotic vertebral fracture.