J Korean Soc Radiol.  2012 May;66(5):473-480. 10.3348/jksr.2012.66.5.473.

The Clinical Significance of Adjacent Rib Involvement on MRI in Patients with Acute Osteoporotic Compression Fractures of the Thoracic Spine

Affiliations
  • 1Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. reonora@schmc.ac.kr
  • 2Department of Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 3Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The purpose of this study was to evaluate the significance of the presence of adjacent rib involvement in osteoporotic compression fractures.
MATERIALS AND METHODS
All the patients with acute osteoporotic compression fractures of the thoracic spine on thoracic spine MRI that presented to our clinic between September 2003 and January 2010 were retrospectively reviewed. All the vertebrae were divided into two groups: those that showed signal-intensity change in the rib adjacent to the compression fracture and those that did not. We compared the results between the two groups to determine if there were differences in the degree of osteoporosis, the compression fracture level and the age of patients between the two groups. We calculated the degree of correlation between the MRI and the bone scan images of these patients. We also reviewed whether percutaneous vertebroplasty relieved symptoms or not.
RESULTS
Signal-intensity changes were found in the adjacent rib(s) in 12 of the 60 patients and in 14 of the 94 levels (the total number of levels). The MRI and bone scan showed significant correlation (p < 0.001). There was a statistically significant difference in the incidence of pain at the one-month outpatient follow-up between the two groups (p = 0.0215).
CONCLUSION
The radiologist should comment on the presence or absence of adjacent rib involvement when reporting on the thoracic spine MRI of patients suffering from osteoporotic compression fractures in order to more accurately determine prognosis.


MeSH Terms

Follow-Up Studies
Fractures, Compression
Humans
Incidence
Osteoporosis
Outpatients
Prognosis
Retrospective Studies
Ribs
Spine
Stress, Psychological
Vertebroplasty

Reference

1. Chung HY. Osteoporosis diagnosis and treatment 2007. J Korean Endocr Soc. 2008. 23:76–108.
2. Riggs BL, Melton LJ 3rd. Involutional osteoporosis. N Engl J Med. 1986. 314:1676–1686.
3. Galibert P, Deramond H, Rosat P, Le Gars D. [Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty]. Neurochirurgie. 1987. 33:166–168.
4. Debussche-Depriester C, Deramond H, Fardellone P, Heleg A, Sebert JL, Cartz C, et al. Percutaneous vertebroplasty with acrylic cement in the treatment of osteoporotic vertebral crush fracture syndrome. Neuroradiology. 1991. 33S:149S–152S.
5. Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, et al. Percutaneous vertebroplasty: state of the art. Radiographics. 1998. 18:311–320.
6. Cvijanovic O, Bobinac D, Zoricic S, Ostojic Z, Maric I, Crncevic-Orlic Z, et al. Age- and region-dependent changes in human lumbar vertebral bone: a histomorphometric study. Spine (Phila Pa 1976). 2004. 29:2370–2375.
7. Park JY, Kim SC, Lee JY, Cha SH. Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures. J Korean Radiol Soc. 2003. 48:433–439.
8. Chung JK, Lee MC. Nuclear Medicine. 2008. 3rd ed. Seoul: Korea Medical Book Publisher;546–550.
9. Yang SO, Kim S, Juhng SK. Imaging diagnosis of osteoporotic fracture. J Korean Med Assoc. 2010. 53:67–75.
10. Hammererg KW, DeWald RL. Senile burst fracture: a complication of osteoporosis. Orthop Trans. 1989. 13:97.
11. Salomon C, Chopin D, Benoist M. Spinal cord compression: an exceptional complication of spinal osteoporosis. Spine (Phila Pa 1976). 1988. 13:222–224.
12. Shikata J, Yamamuro T, Iida H, Shimizu K, Yoshikawa J. Surgical treatment for paraplegia resulting from vertebral fractures in senile osteoporosis. Spine (Phila Pa 1976). 1990. 15:485–489.
13. Rapado A. General management of vertebral fractures. Bone. 1996. 18:3 Suppl. 191S–196S.
14. Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976). 2000. 25:923–928.
15. Kim HJ, Lee SK, Hwang HY, Kim HS, Ko JS, Park SH, et al. Percutaneous vertebroplasty in osteoporotic vertebral body compression fracture. J Korean Radiol Soc. 2001. 44:145–151.
16. Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia. Orthop Clin North Am. 1991. 22:181–187.
17. Groves AM, Cheow HK, Balan KK, Bearcroft PW, Dixon AK. 16 detector multislice CT versus skeletal scintigraphy in the diagnosis of wrist fractures: value of quantification of 99Tcm-MDP uptake. Br J Radiol. 2005. 78:791–795.
18. Kwee TC, Takahara T, Niwa T. Diffusion-weighted whole-body imaging with background body signal suppression facilitates detection and evaluation of an anterior rib contusion. Clin Imaging. 2010. 34:298–301.
19. Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. Clinical consequences of post-traumatic bone bruise in the knee. Am J Sports Med. 2007. 35:990–995.
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