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The impact of preoperative magnetic resonance images on outcome of cemented vertebrae

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Abstract

Refracture of cemented vertebrae is often seen after percutaneous vertebroplasty. The purpose of this prospective study was to evaluate pre-procedural magnetic resonance images (MRI) for the prediction of further collapse and vertebral height loss after vertebroplasty. This study included 81 consecutive patients (73 women and 8 men) with osteoporotic compression fractures. MR studies were performed 1–5 days before vertebroplasty. Patients were followed to evaluate refracture for a minimum of 6 months after treatment. Cox proportional hazards model was used to evaluate relationships between clinical data, covariates on pre-procedural MRI, and the presence of cemented vertebrae refracture. The mean refracture rate was estimated with the Kaplan–Meier method. After a mean follow-up of 23.0 ± 8.2 months, 46 cemented vertebrae (57%) experienced refracture, and the mean loss of anterior vertebral height was 11.3%. The 1-year refracture rate after vertebroplasty was 7%, and rapid increased to 76% in the third year. Cox proportional analysis showed that any 1% decrease in signal intensity on T2-weighted images of the injured vertebra will increase the refracture rate by 0.74% (OR = 0.26, 95% CI 0.08–0.81, p = 0.02), and a 1% increase in the poorly enhanced volume ratio will increase the refracture rate by 4.3% (OR = 5.32, 95% CI 1.22–23.14, p = 0.03). Quantitative pre-procedural MRI appears to be useful in exploring vertebrae with poor bone marrow integrity, which effectively predicts the subsequent refracture of cemented vertebra.

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Acknowledgments

This work was partly supported by grants from Chang Gung Memorial Hospital (Chang Gung Medical Research Project; CMRPG860101 to C.-C. Lui).

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung, 83305, Taiwan

    Wei-Che Lin, Hsiu-Ling Chen, Chun-Yen Yu, Yu-Fan Cheng & Chun-Chung Lui

  2. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan

    Wei-Che Lin

  3. Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Cheng-Hsien Lu

  4. Department of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hung-Chen Wang

  5. Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Re-Wen Wu

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  1. Wei-Che Lin
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Correspondence to Chun-Chung Lui.

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Lin, WC., Lu, CH., Chen, HL. et al. The impact of preoperative magnetic resonance images on outcome of cemented vertebrae. Eur Spine J 19, 1899–1906 (2010). https://doi.org/10.1007/s00586-010-1434-6

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  • DOI: https://doi.org/10.1007/s00586-010-1434-6

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