Clinical importance of posterior vertebral height loss on plain radiography when conservatively treating osteoporotic vertebral fractures
Autor: | Young Hoon Kim, Kee-Yong Ha, Jee-Yong Shin, Yong-Suk Kwon, Jun-Yeong Seo, Kwang-Jung Kim |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty Radiography Thoracic Vertebrae Fracture Fixation Internal 03 medical and health sciences Postoperative Complications 0302 clinical medicine Fractures Compression Humans Medicine Spinal canal Kyphosis 030212 general & internal medicine Aged Retrospective Studies General Environmental Science Aged 80 and over medicine.diagnostic_test business.industry Thoracolumbar spine Magnetic resonance imaging Magnetic Resonance Imaging Body Height Sagittal plane medicine.anatomical_structure Plain radiography Vertebral height Radiological weapon Spinal Fractures General Earth and Planetary Sciences Female Radiology business Osteoporotic Fractures 030217 neurology & neurosurgery Follow-Up Studies |
Zdroj: | Injury. 48:1503-1509 |
ISSN: | 0020-1383 |
Popis: | Purpose To predict spinal canal compromise, the assessment of plain radiography with magnetic resonance imaging (MRI) can aid the detection of vertebral body collapse and prevent the development of neurological deficits. Methods Patients who suffered osteoporotic vertebral fractures (OVFs) between January 2012 and December 2014 underwent consecutive radiological assessments, including measurements of anterior height loss (AHL), posterior height loss (PHL), and the kyphotic angle (KA). The fracture morphology was classified by AOSpine thoracolumbar spine injury classification system. MRI was performed at the initial assessment and the extent of canal encroachment (CE) was calculated in all patients. Follow-up computed tomography (CT) or MRI was performed in patients exhibiting significant height loss in follow-up radiography. The fracture patterns in T1- and T2-weighted MRI were also assessed. Results A total of 485 patients visited our institute for treatment of OVFs and 97 were enrolled; 15 were male and 82 were female. The mean age at initial visit was 70.3 ± 14.6 years. The initial spinal CE was correlated with the initial PHL and the initial AHL. The follow-up CE was correlated with age, the initial PHL, and the difference between the initial and last PHL (ΔPHL(initial-last)). OVFs with both endplate fractures have a greater tendency of posterior wall collapse than those with single endplate fracture. On initial T1-weighted sagittal MRI, a diffuse low signal change pattern of the fractured vertebra was correlated with PHL. Delayed neurological deficits developed in four patients. These patients underwent surgical intervention. Conclusions In patients with simple compression fractures, attention should be paid to the posterior vertebral body and both endplates as well as the T1-weighted MRI findings to allow early detection of spinal canal compromise, which can have devastating consequences. |
Databáze: | OpenAIRE |
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