MRI联合骨代谢指标在骨质疏松椎体压缩性骨折术后疗效评估及不良预后预测中的应用价值OA

Objective To observe the clinical effect of osteoporotic vertebral compression fracture(OVCF)and analyze the value of magnetic resonance imaging(MRI)and bone metabolism indexes in predicting the poor prognosis.Methods A total of 258 OVCF patients admitted to Hangzhou Ninth Peopl's Hospital from March 2021 to March 2023 were selected as study objects.After percutaneous kyphoplasty(PKP)or percutaneous vertebroplasty(PVP),visual analogue scale(VAS)score and Cobb angle were collected.The patients were divided into poor prognosis group and good prognosis group according to whether the fracture was repeated after surgery.MRI and bone metabolism indexes of patients were collected,and the influencing factors of prognosis were analyzed.Results The VAS scores of OVCF patients decreased with the extension of time(P<0.05).One month and three months after surgery,the Cobb angle of injured vertebrae in OVCF patients was significantly lower than that before surgery(P<0.05).The proportion of vertebral fluid signs in poor prognosis group was significantly higher than that in good prognosis group(P<0.05),and N-terminal midragment of osteocalcin(N-MID)and 25-hydroxyvitamin D[25(OH)D]in poor prognosis group were lower than those in good prognosis group(P<0.05).Vertebral fluid signs,N-MID and 25(OH)D were all associated with poor prognosis in OVCF patients(P<0.05).The area under the curve(AUC)of vertebral fluid signs,N-MID and 25(OH)D alone for predicting poor prognosis of OVCF was 0.744,0.872 and 0.822,the sensitivity was 56.5%,87.0%and 73.9%,and the specificity was 92.3%,74.5%and 80.9%,respectively.Above indicators combined AUC,sensitivity and specificity were 0.967,95.7%and 80.9%.Conclusion PKP/PVP can reduce pain and improve function in OVCF patients.MRI vertebral fluid signs,N-MID and 25(OH)D are all factors affecting the poor prognosis of OVCF patients,and the combination of three factors can predict the poor prognosis of OVCF patients.