Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2024; 12(23): 5329-5337
Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5329
Hounsfield units in assessing bone mineral density in ankylosing spondylitis patients with cervical fracture-dislocation
Zhong-Ya Gao, Wei-Lin Peng, Yang Li, Xu-Hua Lu
Zhong-Ya Gao, Wei-Lin Peng, Yang Li, Xu-Hua Lu, Department of Orthopaedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
Co-first authors: Zhong-Ya Gao and Wei-Lin Peng.
Author contributions: Gao ZY and Lu XH contributed to conceptualization; Gao ZY, Li Y, and Peng WL contributed to methodology; Gao ZY and Peng WL contributed to case collection and collation; Gao ZY and Li Y contributed to data statistics and analysis; Gao ZY contributed to writing-original draft preparation; Lu Xa contributed to supervision; Li Y, Peng WL, and Lu XH contributed to review of the manuscript.
Institutional review board statement: This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the Ethics Committee of The Second Affiliated Hospital of Naval Medical University (IRB: 2022-12-0628).
Informed consent statement: Both verbal and written informed consent were obtained from all individual participants included in the study.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: All data can be obtained from the corresponding author (Xu-Hua Lu, No. 415 Fengyang Road, Shanghai, 200003, China. E-mail address: xuhualu415@163.com).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xu-Hua Lu, PhD, Doctor, Department of Orthopaedics, Shanghai Changzheng Hospital, Naval Medical University, No. 415 Fengyang Road, Shanghai 200003, China. xuhualu415@163.com
Received: March 2, 2024
Revised: May 29, 2024
Accepted: June 19, 2024
Published online: August 16, 2024
Processing time: 125 Days and 9.9 Hours
Abstract
BACKGROUND

Cervical spine fracture-dislocations in patients with ankylosing spondylitis (AS) are mostly unstable and require surgery. However, osteoporosis, one of the comorbidities for AS, could lead to detrimental prognoses. There are few accurate assessments of bone mineral density in AS patients.

AIM

To analyze Hounsfield units (HUs) for assessing bone mineral density in AS patients with cervical fracture-dislocation.

METHODS

The HUs from C2 to C7 of 51 patients obtained from computed tomography (CT) scans and three-dimensional reconstruction of the cervical spine were independently assessed by two trained spinal surgeons and statistically analyzed. Inter-reader reliability and agreement were assessed by interclass correlation coefficient.

RESULTS

The HUs decreased gradually from C2 to C7. The mean values of the left and right levels were significantly higher than those in the middle. Among the 51 patients, 25 patients (49.02%) may be diagnosed with osteoporosis, and 16 patients (31.37%) may be diagnosed with osteopenia.

CONCLUSION

The HUs obtained by cervical spine CT are feasible for assessing bone mineral density with excellent agreement in AS patients with cervical fracture-dislocation.

Keywords: Hounsfield unit, Ankylosing spondylitis, Fracture-dislocation, Cervical spine, Osteoporosis

Core Tip: In this study, we analyzed Hounsfield units (HU) for assessing bone mineral density in patients with ankylosing spondylitis who developed cervical spine fracture-dislocation. The HU obtained by cervical spine computed tomography are feasible for assessing bone mineral density with excellent agreement. Subsequently, by analyzing the HU, we described the distribution of vertebral HU in ankylosing spondylitis patients with cervical fracture-dislocation. Among the 51 cervical fracture-dislocation patients with AS, 25 patients (49.02%) were diagnosed with osteoporosis, whereas 16 patients (31.37%) were diagnosed with osteopenia.