An Automatic Identification Method for Vertebral Compression Fractures in X-Ray Images Based on Multi-Stage Deep Learning

Vertebral compression fractures (VCFs) are one of the most common spinal disorders encountered clinically. Untimely diagnosis or inaccurate classification often leads to prolonged pain and functional impairment in patients. To enhance diagnostic accuracy and efficiency, this study addressed the high cost and limited applicability of computed tomography (CT) and magnetic resonance imaging (MRI) examinations by leveraging the universality and convenience of X-ray imaging. We proposed a multi-stage deep learning-based method for identifying vertebral compression fractures. The method first employs Discrete Wavelet Transform-YOLOv5 (DWT-YOLOv5) for preliminary vertebral region localization, followed by Polarized Self-Attention-UNet (PSA-UNet) for precise segmentation. Finally, a ResNet50 network incorporating a Convolutional Block Attention Module (CBAM) performs graded classification, categorizing vertebrae into four types: Non-fracture, Mild fracture, Moderate fracture, and Severe fracture. The experimental results demonstrate that the proposed method achieved average accuracy, precision, recall, specificity, and F1-score of 83.7%, 88.1%, 86.2%, 97.7%, and 87.2%, respectively. The proposed method fully leverages the cost-effectiveness and convenience of X-ray imaging, providing clinicians with an efficient and economical auxiliary diagnostic tool. It enables rapid and accurate identification of vertebral compression fractures in emergency and initial screening scenarios.