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Objective To explore the correlation between the severity of emphysema and osteoporosis in patients with chronic obstructive pulmonary disease (COPD). Methods The chest CT and lumbar vertebral dual X-ray absorptiometry (DXA) examinations were retrospectively analyzed in 120 patients with COPD and 60 healthy control subjects. Severity of emphysema was categorized according to the percentage of low attenuation area (LAA%) as mild, moderate, or severe. The bone mineral density (BMD) T values of lumbar vertebrae were compared between COPD and control, and among the 3 severity groups of emphysema. The correlation between LAA% and T values was evaluated. The LAA% cut-off value in COPD patients for developing osteoporosis was determined using the receiver operating characteristic (ROC) curve. Results The T values decreased significantly in mild (T=0.081依0.74, LAA%=6.83依 1.37), moderate (-1.584依1.08, 15.77依2.81), and severe (-2.77依1.11, 29.26依6.05) emphysema. The LAA% was significantly negatively correlated with BMD T values (R=-0.806, P<0.05). Using the LAA% cutoff value of 19.7%, the area under the ROC curve for predicting osteoporosis was 0.950 (P<0.05) with sensitivity of 94.7% and specificity of 86.6%. Conclusion There is positive correlation between severity of emphysema and osteoporosis with cutoff value of >19.7%LAA%for developing osteoporosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Percutaneous vertebroplasty is one of the effective treatments for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will influence the clinical efficacy. OBJECTIVE: To investigate the influence of the distribution of bone cement in percutaneous vertebroplasty on the early postoperative outcomes after osteoporotic vertebral compression fractures. METHODS: A total of 132 patients, including 52 males and 80 females, with a mean age of (76.3±8.2) years who diagnosed as osteoporotic vertebral compression fractures in First Hospital of Shanxi Medical University from January 2017 to June 2019 were enrolled. All patients were divided into underdispersion group (n=54) and diffuse distribution group (n=78) according to the pattern of cement distribution on postoperative X-rays. Visual analogue scale scores postoperatively, the height of anterior edge and midline of injured vertebrae, Cobb angle of local kyphosis and the incidence of complications after 1-year follow-up were compared between the two groups. The trial was performed in accordance with the relevant ethical requirements for research in the First Hospital of Shanxi Medical University. RESULTS AND CONCLUSION: (1) The visual analogue scale scores were lower at 2 days, 1 and 6 months after operation than those before operation in the two groups (P < 0.05). The visual analogue scale scores at 1 month after operation in the underdispersion group were higher than those in the diffuse distribution group (P < 0.05), and there was no significant difference between the two groups at 2 days and 6 months after operation (P > 0.05). (2) Cobb angle and vertebral body height improved in both groups postoperatively compared to preoperatively (P < 0.05). The difference in Cobb angle and vertebral body height was not statistically significant between the two groups (P > 0.05). (3) The rate of bone cement infiltration was not significantly different between the two groups (P > 0.05). Incidence of recurrent fractures in adjacent vertebrae was lower in the diffuse distribution group than that in the underdispersion group (P < 0.05). (4) These findings confirm that percutaneous vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will affect the surgical results. The bone cement is diffusely distributed, which may reduce the incidence of recurrent fractures in adjacent vertebrae. [ABSTRACT FROM AUTHOR]