Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures?
<i>Background and Objectives</i>: Osteoporotic fractures in the thoracic/lumbar spine pose significant challenges in surgical management, with high risks of complications. This study investigates the role of preoperative CT scans and Hounsfield Units (HUs) in predicting postoperative out...
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2025-01-01
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| Online Access: | https://www.mdpi.com/1648-9144/61/2/227 |
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| author | Ahmed Qretam Julien Ceuterick Maher Ghandour Ümit Mert Christian Herren Miguel Pishnamaz Matthias Knobe Frank Hildebrand Rolf Sobottke Mohamad Agha Mahmoud |
| author_facet | Ahmed Qretam Julien Ceuterick Maher Ghandour Ümit Mert Christian Herren Miguel Pishnamaz Matthias Knobe Frank Hildebrand Rolf Sobottke Mohamad Agha Mahmoud |
| author_sort | Ahmed Qretam |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Osteoporotic fractures in the thoracic/lumbar spine pose significant challenges in surgical management, with high risks of complications. This study investigates the role of preoperative CT scans and Hounsfield Units (HUs) in predicting postoperative outcomes. <i>Materials and Methods</i>: A retrospective study was conducted from November 2015 to January 2018. Sixty-one patients over 60 years of age with unstable osteoporotic thoracolumbar spine fractures (OF: 3–4) were included. Preoperative CT scans were performed to measure HU values. Postoperative standing X-rays were taken at 3–12 months to assess signs of loosening, adjacent fractures, or screw dislodgement. HU was divided into quartiles: Q1 (<56.24), Q2 (56.24–72.63), Q3 (72.63–87.59), and Q4 (>87.59). <i>Results</i>: Out of the 61 patients, 14 (23%) exhibited signs of screw loosening, adjacent fractures, or screw dislodgement within 3 to 12 months postoperatively. The mean HU value measured was 65.21, with a range from 21.43 to 140.7. Notably, all patients with observed loosening or dislodgement had HU values below 68. HU significantly predicted mortality, with the second quartile showing a markedly increased risk (adjusted odds ratio [aOR] = 8.12; <i>p</i> = 0.044). However, HU quartiles were not significant predictors of other outcomes. Other factors (fracture level and ASA classification) also influenced clinical outcomes, particularly mortality. <i>Conclusions</i>: HU values from preoperative CT scans are crucial in predicting the risk of screw loosening, dislodgement, and adjacent fractures in osteoporotic spinal fractures. Integrating HU assessment into clinical practice can improve preoperative planning, allowing for more targeted surgical interventions and better clinical outcomes. |
| format | Article |
| id | doaj-art-139b23c7929c4235b664bdcadf3540e7 |
| institution | DOAJ |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-139b23c7929c4235b664bdcadf3540e72025-08-20T03:12:19ZengMDPI AGMedicina1010-660X1648-91442025-01-0161222710.3390/medicina61020227Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures?Ahmed Qretam0Julien Ceuterick1Maher Ghandour2Ümit Mert3Christian Herren4Miguel Pishnamaz5Matthias Knobe6Frank Hildebrand7Rolf Sobottke8Mohamad Agha Mahmoud9Department of Spine, Neuro- and Orthopedic Surgery, Rhein-Maas Clinic, 52146 Würselen, GermanyDepartment of Spine, Neuro- and Orthopedic Surgery, Rhein-Maas Clinic, 52146 Würselen, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH, 52074 Aachen, GermanyDepartment of Trauma and Orthopaedic Surgery, Helios University Hospital Wuppertal, Univeristy of Witten/Herdecke, 42283 Wuppertal, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH, 52074 Aachen, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH, 52074 Aachen, GermanyDepartments of Traumatology, St. Marien Hospital Ahaus, 48683 Ahaus, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH, 52074 Aachen, GermanyDepartment of Spine, Neuro- and Orthopedic Surgery, Rhein-Maas Clinic, 52146 Würselen, GermanyDepartment of Spine, Neuro- and Orthopedic Surgery, Rhein-Maas Clinic, 52146 Würselen, Germany<i>Background and Objectives</i>: Osteoporotic fractures in the thoracic/lumbar spine pose significant challenges in surgical management, with high risks of complications. This study investigates the role of preoperative CT scans and Hounsfield Units (HUs) in predicting postoperative outcomes. <i>Materials and Methods</i>: A retrospective study was conducted from November 2015 to January 2018. Sixty-one patients over 60 years of age with unstable osteoporotic thoracolumbar spine fractures (OF: 3–4) were included. Preoperative CT scans were performed to measure HU values. Postoperative standing X-rays were taken at 3–12 months to assess signs of loosening, adjacent fractures, or screw dislodgement. HU was divided into quartiles: Q1 (<56.24), Q2 (56.24–72.63), Q3 (72.63–87.59), and Q4 (>87.59). <i>Results</i>: Out of the 61 patients, 14 (23%) exhibited signs of screw loosening, adjacent fractures, or screw dislodgement within 3 to 12 months postoperatively. The mean HU value measured was 65.21, with a range from 21.43 to 140.7. Notably, all patients with observed loosening or dislodgement had HU values below 68. HU significantly predicted mortality, with the second quartile showing a markedly increased risk (adjusted odds ratio [aOR] = 8.12; <i>p</i> = 0.044). However, HU quartiles were not significant predictors of other outcomes. Other factors (fracture level and ASA classification) also influenced clinical outcomes, particularly mortality. <i>Conclusions</i>: HU values from preoperative CT scans are crucial in predicting the risk of screw loosening, dislodgement, and adjacent fractures in osteoporotic spinal fractures. Integrating HU assessment into clinical practice can improve preoperative planning, allowing for more targeted surgical interventions and better clinical outcomes.https://www.mdpi.com/1648-9144/61/2/227Hounsfield unitosteoporoticthoracolumbar disk fracture |
| spellingShingle | Ahmed Qretam Julien Ceuterick Maher Ghandour Ümit Mert Christian Herren Miguel Pishnamaz Matthias Knobe Frank Hildebrand Rolf Sobottke Mohamad Agha Mahmoud Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures? Medicina Hounsfield unit osteoporotic thoracolumbar disk fracture |
| title | Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures? |
| title_full | Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures? |
| title_fullStr | Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures? |
| title_full_unstemmed | Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures? |
| title_short | Does Baseline Hounsfield Unit Predict Patients’ Outcomes Following Surgical Management of Unstable Osteoporotic Thoracolumbar Fractures? |
| title_sort | does baseline hounsfield unit predict patients outcomes following surgical management of unstable osteoporotic thoracolumbar fractures |
| topic | Hounsfield unit osteoporotic thoracolumbar disk fracture |
| url | https://www.mdpi.com/1648-9144/61/2/227 |
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