Torasik Vertebralardaki Dejeneratif Değişikliklerin Değerlendirilmesi ile Erişkinlerde Yaş Tayini

Abstract

Age determination is an important part of personal identification. Age determination is performed in living individuals, deceased persons and skeletal remains. Age determination is required for criminal proceeding, medical assessment or archaeological studies. This practice is also carried out in many forensic sciences and medical sciences, especially forensic medicine. In this study, it is aimed to determine the age of living adults by examining various degenerative features of the thoracic spine. Cases who underwent Chest Computed Tomography scanned by Hacettepe University Hospitals Department of Radiology between 01/01/2022 and 16/05/2022 were evaluated retrospectively. Thoses aged between 20-79 years at the time of the scanning were included. Patients with pathological lesion in the vertebrae, history of vertebral trauma or surgery, congenital anomaly, hip, pelvis, lower extremity deformities, comorbid neurological pathology (CVD, neuropathy), lipodystrophy, history of malignancy, rheumatological disease, immunodeficiency, long-term steroid therapy, registered obesity or osteoporosis diagnosis were excluded from the study. Osteophyte degeneration, facet joint degeneration, disc degeneration, vertebral height loss, vertebral density, cross sectional area of paraspinal muscle volume and paraspinal muscle density, ligament ossification and kyphosis angle were examined using CT images. Thirty two variables were established from these parameters. Variables were compared according to gender and age groups. Receiver operating characteristic curve analysis was used to set the cutoff value of the variables. Univariate and Multivariate Linear Regression Model were performed for each variables. Standard Error of Estimate (SEE), Coefficient of Determination (R2) and Mean Absolute Error (MAE) were calculated to evaluate these regression formula. The mean age of the cases was 49.50±17.35 years. Maximum stage of osteophyte (L max), sum of advanced osteophyte stages (L2-5) and bridging (M3) were found higher in males compared to females. Among other variables, the number of disc degeneration, ligament ossification, sectional cross area of paraspinal muscle volume and muscle density were higher in males, in general. On the other hand, number of advanced facet arthrosis (Facet 2-3) was higher in females. Variables difference between age groups showed statistically significance in both genders. The frequency of degenerative changes increases with age. L-sum (r: 0.846) in males and M-sum (r: 0.819) in females revealed highest correlation with age. The R-squared value of the L0 variable was found to be 0.714 and SEE 9.33 years in males, while the R-squared 0.655 for L0 also Facet 0, SEE was 10.26 years in females, in univariate regression analysis. Multivariate regression analysis was established with the step wise method. It was found that the multivariate equation had smallest error of estimate in males. There were five independent variables in a multiple regression equation. The R-squared value and SEE of that equation were 0.844 and 6.91 years, respectively. According to the results; osteophytes and other degenerative variables in living individuals may be useful for age determination in additon to conventional methods. Further studies with larger sample sizes are needed to estimate age using degenerative changes with more accurate results.