For compression fracture, vertebral body height loss (VBHL) and kyphotic angle (KA) are two important imaging parameters for determining the prognosis and appropriate treatment. This study used previous measurement methods to assess the degree of VBHL and KA, compare and examine differences between various measurement methods, and examine the correlation between relevant measurement parameters and intravertebral cleft (IVC) in the vertebral body. The radiographic images (lateral view of the T-L spine) of 18 patients with a single-level vertebral compression fracture were reviewed. We measured 9 characteristic lengths and angles on plain radiographs, including anterior vertebral height (AVH) and AVH of the adjacent upper and lower levels, middle vertebral height (MVH) and MVH of the adjacent upper and lower levels, posterior vertebral height (PVH), and vertebral body width, and assessed 6 parameters, including vertebral compression ratio (VBCR), percentage of anterior height compression (PAHC), percentage of middle height compression (PMHC), kyphotic angle (KA), calculated kyphotic angle (CKA), and IVC. The results showed that VBCR is a simple and rapid method of VBHL assessment, but it may result in an underestimation of the degree of VBHL compared to PAHC. WhenPMHC<40%orkyphoticangle>15°, the probability of IVC occurring on the vertebral body was higher which means the higher risk of vertebral body instability. The results of this study could provide a reference for surgeons when using imaging modalities to assess the degree of vertebral body collapse.

The relationship between quantitative anatomic parameters in MRI and patient-reported outcomes (PROs) before and after surgery in degenerative lumbar foraminal stenosis remains unknown. We included 58 patients who underwent transforaminal lumbar interbody fusion (TLIF) for single-level degenerative disc disease with foraminal stenosis between February 2013 and June 2020. PROs were evaluated using the visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and EuroQol-5D (EQ-5D). The foraminal parameters assessed using preoperative MRI included foraminal height, posterior intervertebral disc height, superior and inferior foraminal width, and foraminal area. The correlation between foraminal parameters and PROs before operation, at 1 year follow-up, and change from baseline were assessed. The associations between the aforementioned parameters were examined using linear regression analysis. The analysis revealed that among these parameters, superior foraminal width was found to be significantly correlated with ODI and EQ-5D at the 1 year follow-up and with change in ODI and EQ-5D from baseline. The associations remained significant after adjustment for confounding factors including age, sex, body mass index, and duration of hospital stay. The results indicated that in degenerative lumbar foraminal stenosis, decreased superior foraminal width was associated with better improvement in disability and quality of life after TLIF.

Background: Vertebral compression fractures (VCFs) are a common complication of osteoporosis and can lead to severe pain, decreased mobility, and reduced quality of life. Percutaneous vertebroplasty (PVP) is an effective minimally invasive procedure used to treat symptomatic VCFs in pain relieving and functional restorement. Objectives: This study aimed to identify the prognostic factors for the outcomes of PVP in patients with VCFs and evaluate the risk factors associated with new symptomatic compression fractures. Materials and Methods: We conducted a retrospective analysis of patients who underwent single level PVP performed by five surgeons for symptomatic VCFs between June 2013 and January 2015. Patient demographics, clinical characteristics, and radiographic data were collected. The outcome measures include improvement in Visual Analog Scale and Oswestry Disability Index (ODI) following PVP and new compression fracture events diagnosed with radiography during the follow-up period. Multivariate regression analysis was performed to identify the prognostic factors for PVP outcomes and logistic regression analysis was performed to identify the risk factors for new symptomatic compression fractures. Results: A total of 38 patients met the inclusion criteria and were included in the analysis. The mean age was 80.2 years. The average follow-up period was 16.7 months. The present of intra-vertebral cleft (IVC) was found a significant prognostic factor of ODI after the PVP ( P = 0.040). The mean age in the new symptomatic compression fractures group is 83.8 ± 5.4, and in nonnew symptomatic compression fractures group is 78.5 ± 5.9. We identified that age is a risk factor associated with new symptomatic compression fractures ( P = 0.014). Conclusions: Our analysis revealed that preoperative IVC is a poor prognostic factor associated with PVP outcomes. Furthermore, we found the older patient treated with PVP, the higher incidence of new fractures. There are some limitations of our study resulting in bias include retrospective observational study, small sample size, one radiographic reviewer. This study provides valuable insights into the prognostic factors for PVP outcomes in patients with VCFs and identifies the risk factors associated with new symptomatic compression fractures. These findings can aid in patient selection and counseling, as well as guide future research aimed at optimizing the outcomes of PVP procedures and reducing the risk of new fractures.

Background: Calcaneal fractures are challenging to diagnose on routine radiographs and may result in missed diagnoses. Objective: This study compares Convolutional Neural Networks (CNNs) and Vision Transformer (ViT) architectures for detecting calcaneal fractures separately in three standard radiographic views: Anteroposterior (AP), Harris (axial), and Lateral. Methods: A balanced retrospective dataset of 178 patients with complete three-view examinations (89 with displaced calcaneal fractures and 89 controls) was used to evaluate five deep learning models: ResNet50, InceptionV3, InceptionResNetV2, XCiT, and PiT. After image-quality screening, each view underwent an approximately 8:2 image-level training–validation split; no independent test set was used. Images were preprocessed using data augmentation and Contrast Limited Adaptive Histogram Equalization (CLAHE), while Gradient-weighted Class Activation Mapping (Grad-CAM) was employed to visualize model activation. Results: InceptionV3 achieved 100% sensitivity in the AP view, while ResNet50 achieved 100% specificity in both AP and Lateral views. XCiT matched ResNet50 across all five classification metrics in the AP view and matched ResNet50 and InceptionV3 in the Lateral view. PiT achieved 100% accuracy in the Harris validation set (95% CI, 89.0–100.0%). Grad-CAM visualizations showed activation over the calcaneal region in representative fracture images. Conclusions: This study demonstrates the feasibility of deep learning for identifying displaced calcaneal fractures through separate evaluations of AP, Harris, and Lateral radiographs. The model-specific performance patterns provide a foundation for further development of AI-assisted calcaneal fracture detection and future investigation of multi-view integration.