Usefulness of an Early MRI-based Classification System for Predicting Vertebral Collapse and Pseudoarthrosis After Osteoporotic Vertebral Fractures
Usefulness of an Early MRI-based Classification System for Predicting Vertebral Collapse and Pseudoarthrosis After Osteoporotic Vertebral Fractures
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DOI：
10.1097/bsd.0b013e318292b509
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发表时间：
2014-04-01
影响因子：
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通讯作者：
Taguchi, Toshihiko
中科院分区：
文献类型：
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作者：
Kanchiku, Tsukasa;Imajo, Yasuaki;Taguchi, Toshihiko
研究设计：回顾性回顾，目的：阐明早期磁共振成像分类是否可预测假关节和最终椎体塌陷在脊椎骨折的脊椎fracture.Summary背景：脊椎骨折的初始治疗包括卧床休息，矫形器的使用，石膏模型。然而，在某些情况下，由于进行性椎体塌陷或假关节，疼痛持续存在。骨折后立即预测这些并发症，可以促进早期积极治疗，尽管早期预后普遍较差。方法：共109例（129骨折椎体，88名女性，21名男性，平均年龄79岁），随访超过6个月后保守治疗胸腰椎骨折。分析早期正中矢状位T1加权和T2加权磁共振图像。最终椎体塌陷，假关节转换，迟发性脊髓麻痹的发病率进行了回顾性检查，为每一个椎体骨折type.Results：根据T1加权成像为基础的分类，74个椎体（57%）的总型骨折。这种类型的最终椎体塌陷率明显高于其他类型。20例患者（18.3%）的20处全型骨折中观察到假关节;这些患者的假关节转换率明显高于其他患者。全型骨折仅1例（0.9%）发生迟发性脊髓麻痹。根据T2加权像分类，69个椎体有高信号宽型骨折，这是最常见的骨折类型（53%）。低应力宽型骨折与最终椎体塌陷、假关节和迟发性脊髓麻痹的发生率显著较高相关。当总型骨折的T1加权图像为基础的分类进行细分，根据T2加权图像为基础的分类，一个显着较高的假关节转换率观察到低信号宽型fractions.Conclusions：我们的研究结果表明，放射学预后可以估计在有限的范围内，通过确定的程度和范围的骨质疏松性椎体骨折使用早期磁共振成像为基础的分类。
Study Design:Retrospective review.Objective:To clarify whether an early magnetic resonance imaging-based classification predicts pseudoarthrosis and final vertebral collapse in osteoporotic vertebral fractures.Summary of Background:Initial therapy for osteoporotic vertebral fractures involves bed rest, orthotic use, and plaster casts. However, in some cases, pain persists because of progressive vertebral collapse or pseudoarthrosis. Prediction of these complications immediately after fractures can facilitate early proactive treatment despite the early prognosis being generally poor.Methods:A total of 109 patients (129 fractured vertebrae, 88 females, 21 males, and average age 79 y) followed up over 6 months after conservative treatment for thoracolumbar vertebral fractures were included. Early midsagittal T1-weighted and T2-weighted magnetic resonance images were analyzed. The incidence of final vertebral body collapse, pseudoarthrosis conversion, and delayed spinal cord paralysis were examined retrospectively for each vertebral fracture type.Results:According to the T1-weighted image-based classification, 74 of the vertebrae (57%) had total-type fractures. The final vertebral body collapse rate was significantly higher in this type than in others. Pseudoarthrosis was observed in 20 total-type fractures in 20 patients (18.3%); pseudoarthrosis conversion rate was significantly higher in these patients than in others. Delayed spinal cord paralysis occurred in only 1 patient (0.9%) with total-type fracture. According to the T2-weighted image-based classification, 69 vertebrae had the hyperintense wide-type fractures, which was the most common fracture type (53%). Hypointense wide-type fractures were associated with a significantly higher incidence of final vertebral body collapse, pseudoarthrosis, and delayed spinal cord paralysis. When total-type fractures of the T1-weighted image-based classification were subclassified according to the T2-weighted image-based classification, a significantly higher pseudoarthrosis conversion rate was observed in hypointense wide-type fractures.Conclusions:Our results suggest that the radiologic prognosis can be estimated to a limited extent by determining the degree and extent of osteoporotic vertebral fractures using an early magnetic resonance imaging-based classification.