J Korean Neurosurg Soc.  2001 Jul;30(7):907-915.

The Value of Preoperative MRI and Bone Scan in Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

• Kim SH
• Lee WS
• Seo EK
• Shin YS
• Zhang HY
• Jeon P

Abstract

OBJECTIVE
Percutaneous vertebroplasty is often complicated by the presence of multiple fractures or non-localizing pain in the patients with osteoporotic vertebral fractures. The purpose of this study is to estimate the value of preoperative radiologic studies in the localization of symptomatic vertebrae and to determine the factors which can influence on the clinical results.
MATERIALS AND METHODS
We retrospectively reviewed the clinical and radiologic data of 57 vertebrae in 30 patients underwent percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Inclusion criteria was severe pain(McGill-Melzack score 3, 4 or 5) associated with the acute vertebral fractures and absence of spinal nerve root or cord compression sign. Acute symptomatic vertebral fracture was determined by the presence of signal change on MR images or increased uptake on whole body bone scan.
RESULTS
Pain improvement was obtained immediately in all patients and favorable result was sustained in 26 patients(86.7%) during the mean follow-up duration of 4.7 months(5 complete pain relief, 21 marked pain relief). Those who underwent vertebroplasty for all acute symptomatic vertebrae had significantly better clinical result than those who did not. Further vertebral collapse and eventual bursting fracture occurred in 1 vertebra which showed intradiskal leakage of bone cement and disruption of cortical endplate on postoperative CT scan.
CONCLUSION
Preoperative MR imaging and whole body bone scan are very useful in determining the symptomatic vertebrae, especially in the patients with multiple osteoporotic vertebral fractures. To obtain favorable clinical result, the careful radiologic evaluation as well as clinical assessment is required. Control of PMMA volume seems to be the most critical point for avoiding complications.

Keyword

Vertebroplasty; Osteoporotic compression fracture; Spinal MRI; Whole body bone scan

MeSH Terms

Follow-Up Studies
Fractures, Compression*
Humans
Magnetic Resonance Imaging*
Polymethyl Methacrylate
Retrospective Studies
Spinal Nerve Roots
Spine
Tomography, X-Ray Computed
Vertebroplasty*
Polymethyl Methacrylate