Quantitative CT-based bone strength parameters for the prediction of novel spinal implant stability using resonance frequency analysis: a cadaveric study involving experimental micro-CT and clinical multislice CT.,European Radiology Experimental

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Quantitative CT-based bone strength parameters for the prediction of novel spinal implant stability using resonance frequency analysis: a cadaveric study involving experimental micro-CT and clinical multislice CT.
European Radiology Experimental ( IF 3.7 ) Pub Date : 2019-01-22 , DOI: 10.1186/s41747-018-0080-3
Daisuke Nakashima ₁ , Ken Ishii _{1,

2} , Yuji Nishiwaki ₃ , Hiromasa Kawana ₄ , Masahiro Jinzaki ₅ , Morio Matsumoto ₁ , Masaya Nakamura ₁ , Takeo Nagura _{1,

6}

Affiliation

Background

To predict conventional test forces (peak torque and pull-out force) and a new test force (implant stability quotient [ISQ] value of a spinal pedicle screw) from computed tomography (CT) parameters, including micro-architectural parameters, using high-resolution micro-CT and clinical multislice CT (MSCT) in human cadaveric vertebrae.

Methods

Micro-CT scans before/after screw insertion (n = 68) and MSCT scans before screw insertion (n = 58) of human cadaveric vertebrae were assessed for conventional test forces and ISQ value. Three-dimensional volume position adjustment between pre-insertion micro-CT and MSCT scans and post-insertion scans (micro-CT) was performed to extract the volume of the cancellous bone surrounding the pedicle screw. The following volume bone mineral density and micro-architectural parameters were calculated: bone volume fraction, bone surface density (bone surface/total volume (BS/TV)), trabecular thickness, trabecular separation, trabecular number, structure model index, and number of nodes (branch points) of the cancellous bone network/total volume (NNd/TV) using Spearman’s rank correlation coefficient with Bonferroni correction.

Results

Conventional test forces showed the strongest correlation with BS/TV: peak torque, ρ = 0.811, p = 4.96 × 10⁻¹⁷(micro-CT) and ρ = 0.730, p = 7.87 × 10⁻¹¹ (MSCT); pull-out force, ρ = 0.730, p = 1.64 × 10⁻¹² (micro-CT) and ρ = 0.693, p = 1.64 × 10⁻⁹ (MSCT). ISQ value showed the strongest correlation with NNd/TV: ρ = 0.607, p = 4.01 × 10⁻⁸ (micro-CT) and ρ = 0.515, p = 3.52 × 10⁻⁵ (MSCT).

Conclusions

Test forces, including the ISQ value, can be predicted using micro-CT and MSCT parameters. This is useful for establishing a preoperative fixation strength evaluation system.

中文翻译：

基于共振定量分析的基于CT的定量骨强度参数，用于预测新型脊柱植入物的稳定性：一项涉及实验性微型CT和临床多层CT的尸体研究。

背景

要通过计算机断层扫描（CT）参数（包括微体系结构参数）使用高水平的预测力来预测常规的测试力（峰值扭矩和拔出力）和新的测试力（椎弓根螺钉的植入物稳定性商[ISQ]值），尸体椎骨的高分辨率显微CT和临床多层CT（MSCT）。

方法

微CT扫描之前/螺钉插入（后Ñ = 68）和前MSCT螺钉插入（扫描Ñ = 58）评估了人体尸体椎骨的常规测试力和ISQ值。在插入前的微CT和MSCT扫描之间以及插入后的扫描（微CT）之间进行三维体积位置调整，以提取椎弓根螺钉周围的松质骨的体积。计算了以下体积的骨矿物质密度和微结构参数：骨体积分数，骨表面密度（骨表面/总体积（BS / TV）），小梁厚度，小梁分离度，小梁数，结构模型指数和骨密度使用Spearman秩相关系数和Bonferroni校正，计算松质骨网络的节点（分支点）/总体积（NNd / TV）。

结果

常规测试力与BS / TV的相关性最强：峰值扭矩ρ = 0.811，p = 4.96×10 ^-17（micro-CT），ρ = 0.730，p = 7.87×10 ^-11（MSCT）；拔出力ρ = 0.730，p = 1.64×10 ^-12（micro-CT）和ρ = 0.693，p = 1.64×10 ^-9（MSCT）。ISQ值与NNd / TV具有最强的相关性：ρ = 0.607，p = 4.01×10 ^-8（micro-CT）和ρ = 0.515，p = 3.52×10 ^-5 （MSCT）。