Abstract:

Objective To study whether the leading and trailing edge's high level of the compressive vertebral and bone mineral density have relevance or not after falling, in order to provide theoretical basis for forensic clinical identification of vertebral fracture is considered injury/illness relationship, then in order to serve the judicial litigation more scientifically. Methods A total of 365 subjects were selected and divided into trauma group, trauma with osteoporosis group, pathological osteoporotic vertebral fracture group and blank control group. Quantitative CT (QCT) was used to measure the bone mineral density of each subject, MRI was used to measure the height of the anterior and posterior edges of the compressed vertebral body, and the ratio of the anterior to posterior edge height was calculated. SAS 9.3 software was used for data processing, and t-test, χ² test, Fisher's exact test, and one-way variance were used for statistical analysis. Results The correlation coefficient of the vertebral height ratio and bone mineral density is 0.436, but r²＜0.5，so it has no practical significance. Conclusions It has no correlation between the leading and trailing edge's high level of the compressive vertebral after falling down and bone mineral density, so when we use 5.9.3b） of the human body damage degree standard in handling such cases, consider injury/illness relationship is not recommended.

Key words:

forensic clinical medicine, Vertebral Compression Fracture（VCF）, bone mineral density, osteoporosis, relevance

摘要：

目的 研究摔跌坐地后胸腰椎椎体压缩性骨折后，椎体前后缘高度比与骨密度之间的关联性，为该类椎体骨折伤病关系的法医临床鉴定提供理论依据。方法 选择对象共365人，分为外伤组、外伤伴有骨质疏松症组、病理性骨质疏松性椎体骨折组和空白对照组。应用定量CT（QCT）测量每位受试者的骨密度，应用MRI测量压缩椎体前后缘高度，计算前后缘高度比。采用SAS 9.3软件进行数据处理，运用t检验、χ²检验、Fisher精确检验、单因素方差进行统计学分析。结果 高度比与骨密度之间的相关系数为0.436，但r²< 0.5，缺乏统计学意义。结论 摔倒坐地后胸腰椎骨折椎体高度变化与骨密度之间存在关联性的依据不充分，因此在应用《人体损伤程度鉴定标准》相关条款对该类案件进行鉴定时，宜慎重处理考虑伤病关系。

关键词:

法医临床学, 椎体压缩性骨折, 骨密度, 骨质疏松, 关联性