European Spine Journal

, Volume 19, Issue 11, pp 1899–1906

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

  • Wei-Che Lin
  • Cheng-Hsien Lu
  • Hsiu-Ling Chen
  • Hung-Chen Wang
  • Chun-Yen Yu
  • Re-Wen Wu
  • Yu-Fan Cheng
  • Chun-Chung Lui
Original Article

DOI: 10.1007/s00586-010-1434-6

Cite this article as:
Lin, W., Lu, C., Chen, H. et al. Eur Spine J (2010) 19: 1899. doi:10.1007/s00586-010-1434-6

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.

Keywords

Magnetic resonance imagingOsteoporosisSpineVertebral fractureVertebroplasty

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Wei-Che Lin
    • 1
    • 2
  • Cheng-Hsien Lu
    • 3
  • Hsiu-Ling Chen
    • 1
  • Hung-Chen Wang
    • 4
  • Chun-Yen Yu
    • 1
  • Re-Wen Wu
    • 5
  • Yu-Fan Cheng
    • 1
  • Chun-Chung Lui
    • 1
  1. 1.Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiungTaiwan
  2. 2.Department of Biomedical Imaging and Radiological SciencesNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiungTaiwan
  4. 4.Department of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiungTaiwan
  5. 5.Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical CenterChang Gung University College of MedicineKaohsiungTaiwan