ObjectiveTo analyze the relationship between the bone mineral density (BMD) and lumbar intervertebral disc degeneration in rhesus macaques by using T1ρ-MRI. MethodsTwenty female rhesus macaques at the age of 10.9 years on average (rang, 4-20 years) were selected. The lumbar intervertebral discs were classified by Pfirrmann grading system and the T1ρ relaxation time (T1ρ value) was examined by using MRI (Philips 1.5 Tesla), and then BMD values of the L4,5 vertebrae and femoral ward's triangle were detected by using Osteocore dual energy X-ray absorptiometry. Finally, the relationship of T1ρ value of the lumbar intervertebral discs and Pfirrmann grading with age, weight, BMD of lumbar vertebrae and femoral ward's triangle was analyzed. ResultsThe BMD values of lumbar vertebrae and femoral ward's triangle were (0.64±0.17) g/cm2 and (0.67±0.19) g/cm2 respectively, showing no significant difference (t=2.893, P=0.128). According to Pfirrmann grading system, there were 7 cases of grade I, 8 cases of grade Ⅱ, and 5 cases of grade Ⅲ at L4,5 intervertebral discs. The T1ρ value of the lumbar intervertebral disc was (104.08±18.65) ms; the T1ρ values of grades I, Ⅱ, and Ⅲ were (121.31±13.44), (104.73±15.01), and (77.41±11.87) ms, respectively. There was a negative correlation between T1ρ value and the age and the BMD of lumbar vertebrae and femoral ward's triangle. There was a positive correlation between Pfirrmann grading and the variables as listed above. Significant negative linear correlation was also observed between T1ρ value and Pfirrmann grading. ConclusionThe T1ρ value is a reliable index when quantifying lumbar intervertebral disc degeneration, and there is a significant positive correlation between BMD and lumbar intervertebral disc degeneration in rhesus macaques.
We investigated the effects and optimal treatment frequency of pulsed electromagnetic fields (PEMFs) on postmenopausal osteoporosis (PMO). A comparison was performed with the cyclical alendronate and a course of PEMFs in the treatment for postmenopausal osteoporosis on bone mineral density (BMD), pain intensity and balance function. There was no significant difference between the two groups on mean percentage changes from baseline of BMD within 24 weeks after random treatments (P≥0.05). However, at the ends of 48 weeks and 72 weeks, the BMD of the PEMFs group were significantly lower than that of the alendronate group (P<0.05). No significant difference was detected between the two groups with regard to treatment effects on Visual Analogue Scale score, the Timed Up & Go Test and Berg Balance Scale score. Compared with cyclical alendronate, a course of PEMFs was as effective as alendronate in treating PMO for at least 24weeks. So its optimal treatment frequency for PMO may be one course per six months.
ObjectiveTo summarize and analyze the characteristics of L1-L4 vertebrae and hip bone mineral density (BMD) in patients with degenerative lumbar scoliosis under dual energy X-ray absorptiometry (DEXA). MethodsWe collected all the preoperative total spine frontal and lateral X-ray images and DEXA examination results of patients with degenerative lumbar scoliosis who were hospitalized in the Department of Orthopedic Surgery in West China Hospital between August 2013 and August 2014. SPSS 21.0 was used to analyze patients’ age, height and body weight; BMD of each vertebra of L1-L4 vertebrae and L1-L4 vertebrae as a whole, and the T score; BMD of left femoral neck, Ward triangle, greater trochanter, and femoral shaft, and the general BMD of femoral neck, and the T score. ResultsThirty-eight patients with an average age of (67.4±8.2) years were enrolled in this study. DEXA examination results showed that 23.7% (9/38) and 28.9% (11/38) of the patients were osteoporotic in the spine and the hip, respectively; the examination results of total lumbar vertebrae and total femoral neck bones were concordant in 60.5% (23/38) of the patients. For lumbar vertebrae, the BMD from high to low was listed as: L4 vertebra, L3 vertebra, total L1-L4 vertebrae, L2 vertebra, and L1 vertebra. The BMD of L4 vertebra was significantly higher than that of L1 vertebra, and the BMD of lumbar vertebrae from L1 to L4 in turn presented a step-like increasing trend. For hip bones, the BMD from high to low was listed as: femoral shaft, total femoral neck area, femoral neck, greater trochanter, and Ward triangle. The BMD of the femoral shaft was significantly higher than that of Ward triangle. In the whole DEXA examination, the BMD of total L1-L4 lumbar vertebrae and its T score were higher than the BMD of left femoral neck area and its T score, respectively. ConclusionsDegenerative changes of the lumbar spine may lead to misinterpretation of BMD measurements and cause underdiagnosis of osteoporosis with DEXA. Routine reporting of spine BMD at L1 can add valuable information for reassessment and monitoring. The BMD of hip is less affected by osteoarthritis, osteophytes than the lumbar spine, and thus, it will be more meaningful in diagnosing and monitoring of the disease.
ObjectiveTo investigate the femoral bone remodeling and long-term effectiveness of total hip arthroplasty (THA) with anatomic medullary locking (AML) prosthesis.MethodsThe clinical data of 24 cases (26 hips) who were treated with THA with AML prosthesis between November 1997 and January 2003 were retrospectively analyzed. There were 12 males and 12 females with an age of 32-69 years (mean, 53.7 years). There were 5 cases (5 hips) of avascular necrosis of the femoral head, 6 cases (7 hips) of secondary osteoarthritis of the hip dysplasia, 6 cases (6 hips) of femoral neck fracture, 2 cases (2 hips) of primary osteoarthritis, 3 cases (3 hips) of revision surgery, 1 case (2 hips) of ankylosing spondylitis, 1 case (1 hip) of femoral head fracture. The patients were followed up at immediate, 6 weeks, 3 months, 6 months, 1 year, and then every year after operation for imaging evaluation (X-ray film was taken immediately after operation to evaluate the femoral isthmus compression, Engh standard was used to evaluate the biological fixation of the femoral shaft prosthesis, and Brooker method was used to evaluate the occurrence of heterotopic ossification); bone reconstruction evaluation [reconstruction of prosthesis and bone interface (type of bone reaction, Gruen zone, incidence, and occurrence time were recorded), reconstruction of bone around prosthesis (proximal femur stress shielding bone absorption was evaluated according to Engh and Bobyn methods, and bone mineral density change rate was measured)]; clinical efficacy evaluation [Harris score for efficacy, visual analogue scale (VAS) score for thigh pain].ResultsAll patients were followed up 15 years and 2 months to 20 years and 4 months, with a median of 16 years and 6 months. At immediate after operation, 24 hips (92.3%) had good femoral isthums compression, 24 hips (92.3%) had good bone ingrowth. Heterotopic ossification occurred in 2 patients with degree 1, 2 patients with degree 2, and 1 patient with degree 3 at 3-6 months after operation. Hyperplastic bone reactions were more common in Gruen 2, 3, 4, 5, 6, 10, 11, and 12 zones, mainly occurring at 6-20 months after operation, with the incidence of 3.8%-69.2%, with the highest incidence of spot welding. All absorptive bone reactions were osteolysis, which was common in Gruen 1 and 7 zones, and mainly occurred at 8 years after operation, with an incidence of 42.3%. No clear line (area) or enlarged sign of medullary cavity was observed. Twenty-one hips (80.8%) had 1 degree stress shieding, and 5 hips (19.2%) had 2 degree stress shieding. It mainly occurred at 10-24 months after operation in Gruen 1 and 7 zones. Dual energy X-ray absorptiometry showed that bone mineral density mainly decreased in Gruen 1, 2, 6, and 7 zones, mainly increased in Gruen 3, 4, and 5 zones. Bone mineral density loss progressed slowly after 2 years of operation, and it was stable in 5-8 years, but decreased rapidly in 8-9 years, and stabilized after 10 years. The Harris score increased from 51.1±6.2 before operation to 88.3±5.1 at last follow-up (t=–21.774, P=0.000). Mild thigh pain occurred in only 2 cases (7.7%) with the VAS score of 2. No aseptic loosening or revision of femoral prosthesis occurred during the follow-up.ConclusionThe application of AML prosthesis in THA has a good bone remodeling and a good long-term effectiveness.
Objective?To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. Methods? Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. Results?From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=?0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a “W-shaped” manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=?0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). ConclusionSince 1990, the LBMD attributable fracture burden in China’s older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Objective To observe the influence on adjacent lumbar bone density after strengthening of T12, L1 segment vertebral osteoporotic compression fracture by percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in postmenopausal female. Methods Between January 2008 and June 2011, 59 patients with T12, L1 segment thoracolumbar osteoporotic compression fracture were treated with PVP in 29 cases (PVP group) and PKP in 30 cases (PKP group), who were in accordance with the inclusion and exclusion criteria. No significant difference was found in gender, duration of menopause, disease druation, causes of injury, fractured vertebral body, and vertebral fracture classification between 2 groups (P gt; 0.05). The kyphosis Cobb angle of surgical area was measured at preoperation, 1 week after operation, and last follow-up; the lower three lumbar spine bone mineral density (BMD) of the surgical area, the femoral neck BMD, and body mass index (BMI) of patients were measured at perioperative period and last follow-up to find out the statement of anti-osteoporosis; FRAX online tools were used to evaluate the probability of major osteoporotic fracture and hip fracture of the next 10 years. Results The average follow-up was 25.5 months (range, 12-48 months) in 2 groups. There was significant difference in kyphosis Cobb angle of T12, L1 between preoperation and last follow-up in 2 groups (P lt; 0.05); the Cobb angle of PKP group was significantly less than that of PVP group at 1 week after operation and last follow-up (P lt; 0.05). No significant difference was found in BMI between 2 groups, and between perioperative period and last follow-up in the same group (P gt; 0.05). The lower three lumbar spine BMD of the surgical area and its T value at last follow-up was improved significantly when compared with BMD at perioperative period (P lt; 0.05); there was no significant difference in the lower three lumbar spine BMD and its T value between 2 groups at perioperative period (P gt; 0.05), but significant difference was found between two groups at last follow-up (P lt; 0.05). Difference was not significant in the femoral neck BMD and its T value between 2 groups, and between perioperative period and last follow-up in the same group (P gt; 0.05). The probability of major osteoporotic fracture and hip fracture of the next 10 years was not significantly different between 2 groups and between perioperative period and last follow-up in the same group (P gt; 0.05). Conclusion The increased BMD of adjacent lumbar spine can improve the strength of the vertebral body and reduce the incidence of adjacent vertebral fracture in patients with T12, L1 segment vertebral osteoporotic compression fracture after PVP/PKP, and PKP is superior to PVP increasing BMD of adjacent lumbar spine.
In order to meet the requirements of ultrasound bone density measurement, we designed a software based on Visual Studio C++ 2008. The software includes interface design, acquisition and control, data processing and parameter extraction, data storage and printing. Excellent human-computer interface (HCI) will give users a convenient experience. Auto gain control (AGC) and digital filter can improve the precision effectively. In addition, we can observe waveform clearly in real time. By using USB communication, we can send control commands to the acquisition and get data effectively, which can shorten the measuring time. Then we calculated the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Patients' information can be accessed by using XML document. Finally, the software offers printing function.
ObjectiveTo compare the clinical effects of pulsed electromagnetic fields (PEMFs) with oral alendronate in the treatment of postmenopausal osteoporosis. MethodsFourty patients diagnosed to have postmenopausal osteoporosis (OP) from September 2009 to September 2010 were included in our study. They were randomly divided into the experimental group and the control group. All patients were administered the same basic drugs:Caltrate 600 mg and Alfacalcidol 0.5 μg per day. For the experimental group, PEMFs were offered 6 times per week for 5 weeks (30 times in total), and patients in this group were followed up for 12 weeks. For the control group, alendronate was given at a dose of 70 mg per week for 12 weeks. Bone mineral density (BMD), visual analogue scale, and manual muscle testing (MMT) scale were evaluated before, 1 week, 5 weeks, and 12 weeks after intervention. ResultsIncreasing of BMD, pain relieving, and improvement of MMT had a trend of increasing values after 5 weeks of treatment in the experimental group (P<0.05), but there was no significant difference between the two groups (P>0.05). However, there was a significant difference between the two groups in patients' lower back muscle strength after treatment (P<0.05). ConclusionPEMFs have the same effect as alendronate in pain relief, and bone mass and muscle strength improvement, and are even advantageous in increasing back muscle strength compared with alendronate.
In order to meet the requirements of ultrasound bone density measurement, we proposed a software solution to improve the accuracy and speed of measurement of bone mineral density of the ultrasound bone densitometer. We used a high-speed USB interface chip FT232H, along with a high-speed AD converter chip to calculate speed of sound (SOS), broadband ultrasound attenuation (BUA ) and other bone density parameters in the PC software. This solution improved the accuracy of the measurement data, reduced the measurement time and increased the quality of the displayed image. It is well concluded that the new software can greatly improve the accuracy and transmission speed of bone density measurement data through a high-speed USB interface and a software data processing technology.