European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023
CT-based analysis of sagittal and coronal lumbar endplate morphology: multivariate analysis of factors associated with endplate depth.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shima Koichiro, Fujibayashi Shunsuke, Takemoto Mitsuru, Shimizu Takayoshi, Masuda Soichiro, Shimizu Yu, Otsuki Bungo, Murata Koichi, Matsuda Shuichi
Аннотация
PURPOSE: Lumbar endplate morphology varies in individuals; thus, custom-made implants are sometimes more useful than standardized implants. This study aimed to analyze endplate morphology and factors associated with endplate depth using computed tomography (CT) in a non-symptomatic population.
METHODS: In total, 118 lumbar CT images of non-symptomatic individuals without severe degenerative change (aged 20-79 years) were retrospectively reviewed. The following radiographic parameters were measured in each lumbar vertebral segment (T12-S1) to determine endplate depth: superior/inferior endplate depth in the midsagittal and midcoronal planes, disk angle, and height. The relationship between baseline demographics (age, sex, body mass index [BMI], Hounsfield unit of the L1 vertebral body, and pelvic incidence [PI]) and endplate depth was analyzed.
RESULTS: Toward the caudal level, the superior endplate depth increased, sagittal inferior depth decreased, and coronal inferior depth increased. Multivariate analysis revealed that endplate depth was significantly associated with age (p < 0.001), while inferior endplate depth was associated with PI (p = 0.01). Superior endplate depth was associated with female sex (sagittal: p = 0.005, coronal: p = 0.002). Endplate depth, except for the inferior coronal region, was associated with low BMI (sagittal superior: p = 0.005; coronal superior and sagittal inferior: p = 0.02).
CONCLUSION: Endplate depths tend to be larger toward the caudal level, particularly in the superior endplate. Surgeons should thoroughly evaluate the preoperative CT image because various endplate morphologies require attention to cage shape when performing lumbar interbody fusion, especially in patients who are older, are female, have low BMI, and have large PI.
LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
METHODS: In total, 118 lumbar CT images of non-symptomatic individuals without severe degenerative change (aged 20-79 years) were retrospectively reviewed. The following radiographic parameters were measured in each lumbar vertebral segment (T12-S1) to determine endplate depth: superior/inferior endplate depth in the midsagittal and midcoronal planes, disk angle, and height. The relationship between baseline demographics (age, sex, body mass index [BMI], Hounsfield unit of the L1 vertebral body, and pelvic incidence [PI]) and endplate depth was analyzed.
RESULTS: Toward the caudal level, the superior endplate depth increased, sagittal inferior depth decreased, and coronal inferior depth increased. Multivariate analysis revealed that endplate depth was significantly associated with age (p < 0.001), while inferior endplate depth was associated with PI (p = 0.01). Superior endplate depth was associated with female sex (sagittal: p = 0.005, coronal: p = 0.002). Endplate depth, except for the inferior coronal region, was associated with low BMI (sagittal superior: p = 0.005; coronal superior and sagittal inferior: p = 0.02).
CONCLUSION: Endplate depths tend to be larger toward the caudal level, particularly in the superior endplate. Surgeons should thoroughly evaluate the preoperative CT image because various endplate morphologies require attention to cage shape when performing lumbar interbody fusion, especially in patients who are older, are female, have low BMI, and have large PI.
LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.