| Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion: a prospective multicenter study. | |
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MedLine Citation:
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PMID: 21217433 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Prospective multicenter study. OBJECTIVE: To identify radiographic or magnetic resonance (MR) images of fresh vertebral fractures that can predict a high risk for delayed union or nonunion of osteoporotic vertebral fractures (OVFs). SUMMARY OF BACKGROUND DATA: Vertebral body fractures are the most common fractures in osteoporosis patients. Conservative treatments are typically chosen for OVFs, and associated back pain generally subsides within several weeks with residual persistent deformity of the vertebral body. In some patients, OVF healing is impaired and correlated with prolonged back pain. However, assessments such as plain radiograph or MR images taken during the early phase to predict high risks for nonunions of OVFs and/or poor prognoses have not been identified. METHODS: A total of 350 OVF patients from 25 institutes were enrolled in this clinical study. Plain radiograph and MR images of the OVFs were routinely taken at enrollment at the respective institutes. The findings on the plain radiograph and MR images were classified after enrollment in the study. All the patients were treated conservatively without any surgical intervention. After a 6-month follow-up, the patients were classified into two groups, a union group and a nonunion group, depending on the presence of an intravertebral cleft on plain radiograph or MR images. The associations of the images from the first visit with those of the corresponding nonunions at the 6-month follow-up were analyzed by multivariate logistic regression to elucidate specific image characteristics that may predict a high risk for nonunion of OVFs. RESULTS: Forty-eight patients (49 vertebrae) among the 350 patients (363 vertebrae) were classified as nonunions, indicating a nonunion incidence of 13.5% for conventional conservative treatments for OVFs. The statistical analyses revealed that a vertebral fracture in the thoracolumbar spine, presence of a middle-column injury, and a confined high intensity or a diffuse low intensity area in the fractured vertebrae on T2-weighted MR images were significant risk factors for nonunion of OVFs. CONCLUSION: 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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Authors:
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Tadao Tsujio; Hiroaki Nakamura; Hidetomi Terai; Masatoshi Hoshino; Takashi Namikawa; Akira Matsumura; Minori Kato; Akinobu Suzuki; Kazushi Takayama; Wakaba Fukushima; Kyoko Kondo; Yoshio Hirota; Kunio Takaoka |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Spine Volume: 36 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-22 Completed Date: 2011-12-14 Revised Date: 2012-01-13 |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 1229-35 Citation Subset: IM |
Affiliation:
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Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Back Pain / etiology, therapy Female Humans Logistic Models Magnetic Resonance Imaging / methods* Male Multivariate Analysis Osteoporosis / complications* Osteoporotic Fractures / etiology, radiography*, therapy Prospective Studies Risk Assessment Risk Factors Spinal Fractures / etiology, radiography*, therapy |
| Comments/Corrections | |
Comment In:
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Spine (Phila Pa 1976). 2011 Dec 15;36(26):2363
[PMID:
22020583
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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