J Korean Soc Spine Surg.  2008 Mar;15(1):18-22. 10.4184/jkss.2008.15.1.18.

The Usefulness of Bone Scan in the Osteoporotic Vertebral Compression Fracture Patients Treated With Kyphoplasty

• Jun DS
• Shin WJ
• Kim KH

• KMID: 1482839
• DOI: http://doi.org/10.4184/jkss.2008.15.1.18

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To compare the clinical results of kyphoplasty between osteoporotic patients with compression fractures and rib hot uptake on bone scan and patients without rib hot uptake. SUMMARY OF LITERATURE REVIEW: The incidence of osteoporotic rib fractures is 0.3% in postmenopausal women.
MATERIALS AND METHODS
Between July 2005 and July 2006, 72 kyphoplasties for osteoporotic vertebral compression fractures were performed, and all patients had a bone scan study. On bone scan study, 41 patients (57.7%) had hot uptake in their ribs. Results were assessed by visual analog scale (VAS).
RESULTS
The incidence of hot uptake was 67.8% in thoracic fractures, 40.0% in lumbar fractures, and 72.7% in thoracolumbar fractures. Hot uptake was significantly more common with thoracic and thoracolumbar fractures than with lumbar fractures (p<0.05). The incidence of hot uptake was 49.1% in one- and two-level fractures and 84.6% in over three-level fractures. This finding demonstrated significant difference between the two groups (p<0.05). The mean VAS scores for all cases were 8.2/3.4/3.2 at preoperative/immediate postoperative/after 3 months, respectively. In thoracic fractures, they were 8.2/3.9/3.1; lumbar fractures 8.0/3.2/3.1; and thoracolumbar fractures 8.3/3.7/3.0, respectively. The immediate postoperative VAS score in lumbar fractures was better than in thoracic fractures (p<0.05). The VAS scores in thoracic fractures with hot uptake were 8.3/4.1/3, and those without hot uptake were 7.8/2.8/3.0. The immediate VAS score in thoracic fractures without hot uptake was better than in those with hot uptake (p>0.05).
CONCLUSIONS
Thoracic and multiple osteoporotic compression fractures are often accompanied by rib fractures. Bone scan is a useful tool to detect rib fractures and predict the prognosis of kyphoplasty.

Keyword

Rib fracture; Compression fracture; Bone scan; Kyphoplasty

MeSH Terms

Fractures, Compression
Humans
Incidence
Kyphoplasty
Prognosis
Retrospective Studies
Rib Fractures
Ribs

Figure

• 

  Fig. 1. 66 years old female patient who slipped down one month ago has back pain. (A) T1 and T2-weighted MRI film demonstrate signal change at T8 vertebral body. (B) Bone scan demonstrates hot uptake at thoracic vertebra. (C) Post kyphoplasty radiographs demonstrate the cement augmentation at vertebral body.

• 

  Fig. 2. 75 years old female patient who slipped down 3 weeks ago has pain on back and left chest. (A) T1 and T2-weighted MRI film demonstrate signal change at T11 vertebral body. (B) Bone scan demonstrates hot uptake at thoracic vertebra and left side multiple ribs. (C) Post kyphoplasty radiographs demonstrate the cement augmentation at vertebral body.

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