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A modification and validation of quantitative morphometry classification system for osteoporotic vertebral compressive fractures in mainland Chinese

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Abstract

Summary

This study described a modified quantitative morphometry (mQM) system adapted to specific reference values for Mainland Chinese population. The mQM system is validated using the Genant Semiquantative system and is sensitive for detecting vertebral height changes and predicting cement leakage after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compressive fracture (OVCF).

Introduction

OVCF is a manifestation of osteoporosis. To improve clinical management of osteoporosis, the quantitative morphometry (QM) system has been widely used for the early diagnosis and precise classification of OVCF in developed countries. Here, we present an mQM system and validated its use in detecting OVCF in Mainland Chinese.

Methods

Using our mQM system, the pre- and post-operative values of vertebral heights were measured and evaluated in 309 Mainland Chinese who received percutaneous kyphoplasty (PKP) as OVCF treatment. Measurements and classification of fractures from the mQM system were validated by comparing to values obtained by the Genant semiquantative (SQ) method. Moreover, we evaluated the sensitivity of the mQM system by its ability to detect restoration of vertebral heights and predict cement leakage after PKP.

Results

The five classification of fractures, No deformity (ND), anterior wedge (AW), posterior wedge (PW), biconcavity (BC), and compression (CP), evaluated by the mQM method shared similar distribution characteristics compared to those obtained by the SQ method. In addition, mQM evaluation showed that the vertebra height of all fracture types showed significant restoration after PKP. The incidence of cement leakage was most common in CP (37.5%), followed by AW (31.6%), BC (26.5%), ND (23.7%), and PW (0.0%).

Conclusions

Our mQM system is suitable for classification of fractures, detection of vertebral height restoration, and correlation of cement leakage after PKP in Mainland Chinese population.

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Acknowledgments

The authors thank Dr. Jasper H.N. Yik from the University of California, Davis, for editing this manuscript.

Funding

The authors thank the National Natural Science Fund of China (grant No: 81501912) and Zhejiang Provincial Natural Science Foundation of China (grant No: LQ15H060001) to Zi’ang Hu, as well as the National Natural Science Fund of China (grant No: 11701509) and China Postdoctoral Science Foundation (grant No: 2017M612021) to Li-Li Wang.

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Author notes

  1. L.-J. Song, L.-L. Wang and L. Ning contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China

    L.-J. Song, L. Ning, S.-W. Fan, X. Zhao, Y.-L. Chen, Z.-Z. Li & Z.-A. Hu

  2. Sir Run Run Shaw Institute of Clinical Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China

    L.-J. Song, L. Ning, S.-W. Fan, X. Zhao, Y.-L. Chen, Z.-Z. Li & Z.-A. Hu

  3. School of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, China

    L.-L. Wang

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Song, LJ., Wang, LL., Ning, L. et al. A modification and validation of quantitative morphometry classification system for osteoporotic vertebral compressive fractures in mainland Chinese. Osteoporos Int 29, 2495–2504 (2018). https://doi.org/10.1007/s00198-018-4641-3

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