利用雙能量X光測量儀於單一部位骨折對於骨質密度與骨折率之影響

BMD Result and Fracture Rate Effected by Single-Site Fracture on DXA Study

陳保良(Pao-Liang Chen) ； 王昱豐(Yuh-Feng Wang) ； 廖建國(Jian-Guo Liao) ； 莊紫翎(Tzyy-Ling Chuang)

《核子醫學暨分子影像雜誌》 34卷3期 (2021/09) Pp. 115-124

https://doi.org/10.6332/ANMMI.202109_34(3).0001

摘要

背景：本篇研究目的將探討三個部位（腰椎與雙側髖部骨質密度）均能分析與單一部位不能分析（腰椎與雙側髖部骨質密度任一部位）－因手術而無法分析，二組間各部位的骨質密度差異性，也進一步探討十年骨折率的變化。方法：本篇為回溯性研究，收集自2014年11月至2021年3月間，於臺灣南部某區域教學醫院，接受門診骨質密度檢測之受檢者，將受檢者分成二個組別，控制組（腰椎、左側髖部、右側髖部）三個部位均能分析，手術組（腰椎、左側髖部、右側髖部）只要一個部位開刀，不包含同時二個部位開刀，我們依據受檢者開刀部位分成二組分析。手術包括脊椎手術史（鋼釘內固定、椎體成形術或金屬植入物），髖部手術史（全髖關節置換手術或鋼釘內固定）。結果：本篇研究初步發現，利用骨質密度檢測三個部位，當有一部位因手術後無法評估時，與三個部位都能評估相比，將因手術部位影響骨密度評估，手術患者仍較控制組其骨質密度數值較低，骨折風險增加。結論：因此，本篇研究結論，研究發現金屬植入物固定手術後骨質密度會相較於控制組低，相對骨折率也比控制組高。因此未來建議臨床醫師定期追蹤金屬植入物術後骨質密度之變化，以降低再次骨折之狀況。

關鍵字

骨質密度 ； 骨折 ； 骨折率

並列摘要

Background: The purpose of this study is to compare all three parts (including lumbar spine and bilateral hip) bone mineral density (BMD) that can be analyzed and a single part BMD that cannot be analyzed (any part of the lumbar spine and bilateral hip) due to surgery. Between the two groups, the difference in BMD of different parts and the change of fracture rate in 10 years are further evaluated. Methods: This is a retrospective study. Data were collected from November 2014 to March 2021, in a regional teaching hospital in southern Taiwan, including the subjects who underwent an outpatient BMD exam. The subjects were divided into two groups: the control group (all three parts-the lumbar spine, the left hip, and the right hip that can be analyzed), and the surgical group (one part of the lumbar, the left hip, or the right hip that underwent surgery, and data were excluded if two parts underwent surgery). Based on the surgical history, the subjects were divided into two groups for analysis, including spinal surgery (open reduction and internal fixation, vertebroplasty, or metal prosthesis), hip surgery (total hip replacement or internal fixation with steel nails). Results: This study initially found that when we use BMD to detect three parts, if one part cannot be assessed after surgery, compared with all three parts, the BMD of the surgical patients is lower than that of the control group, and the risk of fractures increases because the surgical part affects the BMD assessment. Conclusions: Therefore, this study concluded that, in the future, clinicians should regularly follow up changes in BMD when metal implants are implanted to reduce re-fractures.

並列關鍵字

bone mineral density ； fracture ； fracture rate