Classification of symptomatic osteoporotic compression fractures of the thoracic and lumbar spine

Wu, Chieh‐Tsai; Lee, Sai-Cheung; Lee, Shih‐Tseng; Chen, Jyi-Feng

doi:10.1016/j.jocn.2004.11.021

Cited by 37 publications

(29 citation statements)

References 25 publications

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“…Wu et al 14 previously reported that fractures involving both the anterior and segments also exhibited signifi cantly high ORs (OR = 4.3, 95% CI = 1.5-12.3, P < 0.01; OR = 4.2, 95% CI = 2.2-7.8, P < 0.001; and OR = 2.6, 95% CI = 1.1-6.0, P = 0.02, respectively).…”

Section: Resultsmentioning

confidence: 99%

Characteristic Radiographic or Magnetic Resonance Images of Fresh Osteoporotic Vertebral Fractures Predicting Potential Risk for Nonunion

Tsujio

Nakamura²,

Terai³

et al. 2011

Spine

154

118

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The results of this study revealed significant relationships between plain radiograph and MR images of acute phase OVFs and the incidence of nonunion. As these risk factors are defined more clearly and further validated, they may become essential assessment tools for determining subsequent OVF treatments. Patients with one or more of the earlier-described risk factors for nonunion should be observed carefully and provided with more intensive treatments.

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Section: Resultsmentioning

confidence: 99%

Characteristic Radiographic or Magnetic Resonance Images of Fresh Osteoporotic Vertebral Fractures Predicting Potential Risk for Nonunion

Tsujio

Nakamura²,

Terai³

et al. 2011

Spine

154

118

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“…Vacuum clefts represent avascular necrosis and seem to occur predominantly in the thoracolumbar junction in elderly men [20,21]. Wu et al [22] demonstrated that those non-union fractures achieve a greater height gain after vertebroplasty and a better reduction of the kyphotic angle. Orler et al [23] recently reported an extended vertebroplasty technique with active restoration of vertebral heights by using a bipedicular placement of bone cannulas in both adjacent, non-fractured vertebral bodies.…”

Section: Discussionmentioning

confidence: 99%

Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures

Pitton¹,

Morgen²,

Herber³

et al. 2007

Eur Radiol

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The height gain of vertebral bodies after vertebroplasty and geometrical stability was evaluated over a one-year period. Osteoporotic fractures were treated with vertebroplasty. The vertebral geometry and disc spaces were analysed using reformatted computed tomography (CT) images: heights of the anterior, posterior, and lateral vertebral walls, disc spaces, endplate angles, and minimal endplate distances. Vertebrae were assigned to group I [severe compression (anterior height/posterior height) <0.75] and group II (moderate compression index >0.75). A total of 102 vertebral bodies in 40 patients (12 men, 28 women, age 70.3 +/- 9.5) were treated with vertebroplasty and prospectively followed for 12 months. Group I showed a greater benefit compared with group II with respect to anterior height gain (+2.1 +/- 1.9 vs +0.7 +/- 1.6 mm, P < 0.001), reduction of endplate angle (-3.6 +/- 4.2 vs -0.8 +/- 2.3 degrees , P < 0.001), and compression index (+0.09 +/- 0.11 vs +0.01 +/- 0.06, P < 0.001). At one-year follow-up, group I demonstrated preserved anterior height gain (+1.5 +/- 2.8 mm, P < 0.015) and improved endplate angle (-3.4 +/- 4.9 degrees , P < 0.001). In group II, the vertebral heights returned to and were fixed at the pre-interventional levels. Vertebroplasty provided vertebral height gain over one year, particularly in cases with severe compression. Vertebrae with moderate compression were fixed and stabilized at the pre-treatment level over one year.

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“…Painful osteoporotic VCFs were defined as the presence of non-radiating back pain that increases with weight bearing or can be exacerbated by manual palpation or knocking of the spinous process of the involved vertebra, and having at least one of the following features on serial plain films and/or MR images: progressively decreased vertebral body height, presence of intravertebral clefts, presence of bone marrow edema [1][2][3][4][5][6][7][8][9] . In general, fractures with bone edema showed enhancement of vertebral bodies in the post-contrast T1-weighted MRI 8 .…”

Section: Methodsmentioning

confidence: 99%

“…Painful vertebral compression fractures (VCFs) usually have at least one of the following features on radiographs and/or MR images: progressively decreased vertebral body height, intravertebral clefts, and bone marrow edema [1][2][3][4][5][6][7][8][9] . Healed osteoporotic VCFs without bone marrow edema and intravertebral clefts are usually not indicated for VP because these patients usually experience little or no pain relief after VP [1][2][3]5,7 . Radiographs and magnetic resonance imaging can help determine the site of painful osteoporotic VCFs if pain and tenderness on palpation or knocking of the spinous process was mild or unclear 8 .…”

Section: Introductionmentioning

confidence: 99%

Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

et al. 2008

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We evaluated the detectability of painful vertebral compression fractures (VCFs) on different MRI protocols in 40 osteoporotic patients with thoraco-lumbar osteoporotic vertebral fractures. Five hundred and ten thoracic and lumbar vertebrae in 40 patients were evaluated. All patients underwent percutaneous vertebroplasty. Vertebral fractures were found in 126 (24.7%) of 510 vertebrae. Healed vertebral fractures were found in 33 (26.2%) of 126 vertebral fractures. Painful osteoporotic VCFs was found in 93 (73.8%) of 126 fractures. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of contrast-enhanced MR images, and the non-contrasted combined protocol (including T1-weighted, T2-weighted and STIR images) for the detection of painful osteoporotic VCFs were all more than 90%. Therefore, the non-contrasted combined protocol can be used for detection of painful osteoporotic VCFs prior to percutaneous vertebroplasty, unless there are conditions where contrast-enhanced MR is needed to rule out other causes of VCFs.

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Classification of symptomatic osteoporotic compression fractures of the thoracic and lumbar spine

Cited by 37 publications

References 25 publications

Characteristic Radiographic or Magnetic Resonance Images of Fresh Osteoporotic Vertebral Fractures Predicting Potential Risk for Nonunion

Characteristic Radiographic or Magnetic Resonance Images of Fresh Osteoporotic Vertebral Fractures Predicting Potential Risk for Nonunion

Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures

Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

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