Bone Mineral Density Distribution in the Posterior Wall of the Lateral Mass Evaluated by Computed Tomography Osteoabsorptiometry.

Asian journal of neurosurgery Pub Date : 2024-11-19 eCollection Date: 2025-03-01 DOI:10.1055/s-0044-1793929
Kazuma Doi, Nozomu Inoue, Satoshi Tani, Junichi Mizuno
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Abstract

Objective  Cervical open-door laminoplasty using plates and miniscrews is gaining popularity. One of the complications of this procedure is the loosening or back-out of the miniscrews inserted in the lateral mass (LM). Bone mineral density (BMD) measured by computed tomography (CT) has been used as a predictor of bone strength. However, bone density distribution in the LM remains unclear. Materials and Methods  We investigated bone density distribution in the posterior wall of the LM. A total of 120 LMs were analyzed from the patients who underwent laminoplasty. The distribution of BMD defined by Hounsfield unit (HU) in the posterior wall of the LM was measured by CT osteoabsorptiometry. The posterior wall was divided into nine zones, which consisted of three columns (lateral, center, and medial) and three rows (cranial, center, and caudal). BMD in each zone was averaged and compared by zones and cervical levels. Results  Overall mean ± standard deviation BMD was 1,092 ± 433 HU. Averaged BMD in the entire posterior wall was highest at C4 (1,365 ± 459 HU), second highest at C3 (1,239 ± 435 HU), and lower in the lower levels. BMD in the medial-center zone (1,357 ± 443 HU) was the highest in all zones. BMD in the medial-caudal region at C7 was only 59% of the highest BMD in the medial-center region at C4. Conclusion  The medial-center to the cranial region was most suitable for miniscrew fixation for laminoplasty. These biomechanical findings would be useful in the preoperative planning of laminoplasty especially for the determination of the LM screw entry points and in the design of laminoplasty implants.

用计算机断层骨吸收仪评估侧块后壁的骨密度分布。
目的利用钢板和微型螺钉进行颈椎开门椎板成形术。该手术的并发症之一是插入侧块(LM)的微型螺钉松动或脱出。通过计算机断层扫描(CT)测量的骨矿物质密度(BMD)已被用作骨强度的预测指标。然而,骨密度在LM中的分布仍不清楚。材料与方法我们研究了LM后壁的骨密度分布。总共分析了120例椎板成形术患者的LMs。采用CT骨吸收仪测量LM后壁Hounsfield单位(HU)定义的骨密度分布。后壁分为9个区,包括3列(外侧、中心和内侧)和3列(颅、中心和尾侧)。取每个区域的骨密度平均值,并按区域和颈椎水平进行比较。结果总体平均±标准差BMD为1092±433 HU。整个后壁平均骨密度在C4处最高(1365±459 HU),在C3处次之(1239±435 HU),在较低水平处较低。中央区骨密度最高(1357±443 HU)。C7内侧尾侧区的骨密度仅为C4内侧中心区的最高骨密度的59%。结论椎板成形术中,椎板内侧中心向颅区是最合适的微型固定方式。这些生物力学结果将有助于椎板成形术的术前规划,特别是确定LM螺钉入路点和椎板成形术植入物的设计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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