Top

European Spine Journal

Published in:

01-12-2014 | Original Article

Can MRI predict subsequent pseudarthrosis resulting from osteoporotic thoracolumbar vertebral fractures?

Authors: Hirotsugu Omi, Toru Yokoyama, Atsushi Ono, Takuya Numasawa, Kanichiro Wada, Yoichi Fujisawa

Published in: European Spine Journal | Issue 12/2014

Abstract

Purpose

The purpose of this study was to assess the ability of short inversion time inversion-recovery (STIR) in magnetic resonance imaging for predicting the prognosis of osteoporotic vertebral fractures.

Methods

We analyzed 63 vertebrae of 56 patients who had osteoporotic vertebral fracture (Th10–L2) prospectively. Image finding of a homogeneous high signal change on a fractured vertebra was evaluated and all vertebrae were divided into “homogenous high signal change group” or “non-homogenous high signal change group”. On the other hand, image finding of linear black signal area was evaluated and all vertebrae were divided into “linear black signal area group” or “non-linear black signal area group”.

Results

Sixteen and 24 vertebrae were included in the homogenous high signal change group or the linear black signal area group, respectively. The 16 homogenous high signal change cases did not result in non-union, and 47 non-homogenous high signal change cases resulted in 14 non-unions, a significant difference. Twenty-four linear black signal area and 39 non-linear black signal area cases resulted in 10, and 4 non-unions, respectively, also a significant difference. The kyphosis progression rate of the linear black signal area group (mean 35 %) was significantly higher than that of non-linear black signal area group (mean 23 %). The visual analog scale of back pain of the linear black signal area group (mean 35 mm) was significantly higher than that of the non-linear black signal area group (mean 23 mm).

Conclusions

STIR was useful for predicting bone union, kyphosis, and back pain in patients with osteoporotic vertebral fracture.

Kanchiku T, Taguchi T, Kawai S (2003) Magnetic resonance imaging diagnosis and new classification of the osteoporotic vertebral fracture. J Orthop Sci 8:463–466PubMedCrossRef

Kado DM, Lui LY, Ensrud KE, Fink HA, Karlamangla AS, Cummings SR (2009) Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann Intern Med 150:681–687PubMedCentralPubMedCrossRef

Baba H, Maezawa Y, Kamitani K, Furusawa N, Imura S, Tomita K (1995) Osteoporotic vertebral collapse with late neurological complications. Paraplegia 33:281–289PubMedCrossRef

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521PubMedCrossRef

Ito Z, Harada A, Matsui Y, Takemura M, Wakao N, Suzuki T, Nihashi T, Kawatsu S, Shimokata H, Ishiguro N (2006) Can you diagnose for vertebral fracture correctly by plain X-ray? Osteoporos Int 17:1584–1591PubMedCrossRef

Spiegl UJ, Beisse R, Hauck S, Grillhosl A, Buhren V (2009) Value of MRI imaging prior to a kyphoplasty for osteoporotic insufficiency fractures. Eur Spine J 18:1287–1292PubMedCentralPubMedCrossRef

Harada A, Matsuyama Y, Nakano T, Deguchi M, Kuratsu S, Sueyoshi Y, Yonezawa Y, Wakao N, Machida M, Ito M (2010) Nationwide survey of current medical practices for hospitalized elderly with spine fractures in Japan. J Orthop Sci 15:79–85PubMedCrossRef

Tsujio T, Nakamura H, Terai H, Hoshino M, Namikawa T, Matsumura A, Kato M, Suzuki A, Takayama K, Fukushima W, Kondo K, Hirota Y, Takaoka K (2011) Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion: a prospective multicenter study. Spine 36:1229–1235PubMedCrossRef

Kanchiku T, Taguchi T, Toyoda K, Fujii K, Kawai S (2003) Dynamic contrast-enhanced magnetic resonance imaging of osteoporotic vertebral fracture. Spine 28:2522–2526 (discussion 2522)

10.

Lin WC, Chen HL, Lu CH, Wang HC, Wu RW, Cheng YF, Lui CC (2011) Dynamic contrast-enhanced magnetic resonance imaging for evaluating intraosseous cleft formation in patients with osteoporotic vertebral compression fractures before vertebroplasty. Spine 36:1244–1250PubMedCrossRef

11.

Hashidate H, Kamimura M, Nakagawa H, Takahara K, Uchiyama S (2006) Pseudoarthrosis of vertebral fracture: radiographic and characteristic clinical features and natural history. J Orthop Sci 11:28–33PubMedCrossRef

12.

Niimi R, Kono T, Nishihara A, Hasegawa M, Matsumine A, Sudo A (2014) Efficacy of the dynamic radiographs for diagnosing acute osteoporotic vertebral fractures. Osteoporos Int 25:605–612PubMedCrossRef

13.

Hasegawa K, Homma T, Uchiyama S, Takahashi H (1998) Vertebral pseudarthrosis in the osteoporotic spine. Spine 23:2201–2206PubMedCrossRef

14.

Kanchiku T, Imajo Y, Suzuki H, Yoshida Y, Taguchi T (2014) Usefulness of an early MRI-based classification system for predicting vertebral collapse and pseudoarthrosis after osteoporotic vertebral fractures. J Spinal Disord Tech 27:E61–E65PubMedCrossRef

15.

Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373:1016–1024PubMedCrossRef

16.

Kallmes DF, Ba Comstock, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579PubMedCentralPubMedCrossRef

17.

Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568PubMedCrossRef

18.

Edidin AA, Ong KL, Lau E, Kurtz SM (2011) Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. J Bone Miner Res 26:1617–1626PubMedCrossRef

19.

Linn J, Birkenmaier C, Hoffmann RT, Reiser M, Baur-Melnyk A (2009) The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography? Spine (Phila Pa 1976) 34:E88–E93

20.

Theodorou DJ (2001) The intravertebral vacuum cleft sign. Radiology 221:787–788PubMedCrossRef

21.

Mirovsky Y, Anekstein Y, Shalmon E, Peer A (2005) Vacuum clefts of the vertebral bodies. Am J Neuroradiol 26:1634–1640PubMed

22.

Yu CW, Hsu CY, Shih TT, Chen BB, Fu CJ (2007) Vertebral osteonecrosis: MR imaging findings and related changes on adjacent levels. Am J Neuroradiol 28:42–47PubMedCrossRef

Title: Can MRI predict subsequent pseudarthrosis resulting from osteoporotic thoracolumbar vertebral fractures?
Authors: Hirotsugu Omi
Toru Yokoyama
Atsushi Ono
Takuya Numasawa
Kanichiro Wada
Yoichi Fujisawa
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 12/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3490-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Can MRI predict subsequent pseudarthrosis resulting from osteoporotic thoracolumbar vertebral fractures?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2014

Optimal surgical care for adolescent idiopathic scoliosis: an international consensus

Combined spinal arthrodesis with instrumentation for the management of progressive thoracolumbar kyphosis in children with mucopolysaccharidosis

Association between the ESR1 -351A>G single nucleotide polymorphism (rs9340799) and adolescent idiopathic scoliosis: a systematic review and meta-analysis

Adolescent idiopathic scoliosis surgery with patient-specific screw placement-guides

Late collapse osteoporotic vertebral fracture in an elderly patient with neurological compromise

Are current scoliosis school screening recommendations evidence-based and up to date? A best evidence synthesis umbrella review