X光胸腰椎站立側位照與橫向側位照對壓迫性骨折之研究

脊椎壓迫性骨折大多是因為骨質疏鬆、創傷外力因素或病理性骨折引起，尤其以大於60歲以上女性並可能伴隨跌倒或外力撞擊而造成脊椎不可逆的傷害；壓迫性骨折常好發位置在胸腰椎交界處，造成椎體呈現揳型或魚骨狀，臨床上常規胸腰椎側位攝影，但多為站立側位姿或者為側躺側位姿，因此本研究的目的，採用橫向胸腰椎側位攝影姿勢，可供臨床評估脊椎壓迫性骨折新舊之鑑別診斷。研究使用半圓形輔助海綿置於疑似壓迫性脊椎後側並使用60度三角形海綿輔助器讓膝關節成屈膝姿勢置放於上方，膝關節成屈膝姿勢可讓病患胸腰椎輕鬆平整貼近於硬床板上，讓病患於最舒服的狀態下，配合橫向胸腰椎攝影姿勢技術取得最佳化之影像。使用第一種量測椎體厚度成對樣本T－檢定分析計算出來的p＜0.05；並且使用第二種量測椎體角度成對樣本T－檢定分析計算出來的p＜0.05兩種量測方式出來的值遠小於0.05可以證明成對雙樣本T檢定為有差異性的，對於壓迫性骨折的病患較有實質性幫助，並且更容易臨床上鑑別診斷。

關鍵字

壓迫性骨折；椎體壓迫性骨折；脊椎攝影；脊椎橫向側位攝影

並列摘要

Compression fractures of the spine are mostly caused by osteoporosis, external traumatic factors or pathological fractures, especially in women over 60 years of age and may cause irreversible spine injuries due to falls or external impact; compression fractures often occur in the thoracolumbar spine at the junction, the vertebral body appears to be ＂bone-shaped＂. Clinically, thoracolumbar spine lateral photography was used, but most of them are standing sideways or lying sideways. Therefore, the purpose of this study was use cross-table lateral view photography posture can be used for clinical evaluation of the differential diagnosis of old and new spinal compression fractures. The study, a semicircular auxiliary sponge was placed on the back of the suspected compression spine and a 60-degree triangular sponge assist was used to place the knee joint in a bent knee position. The knee joint in a flexed knee posture allows the patient's thoracic and lumbar spine to be flat and close to the hard bed board in order to let patients in the most comfortable state, with cross-table spine view technology to obtain the best image. The p-value calculated by Paired Samples t-test using the first measurement of vertebral body thickness was less than 0.005 and the Paired Samples t-test using the second measurement of vertebral body angle. The p-value calculated by the Paired Samples T-test was less than 0.005 and the values obtained by the two measurement methods are far less than 0.05, which can prove that the paired two-sample T-test was different, for patients with compression fractures. It is more substantive and easier to make clinical differential diagnosis.

並列關鍵字

compression fractures ； VCFs ； spine X-ray ； cross-table lateral view

國際替代計量

X光胸腰椎站立側位照與橫向側位照對壓迫性骨折之研究

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