J Korean Orthop Assoc.  2018 Aug;53(4):341-349. 10.4055/jkoa.2018.53.4.341.

The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture

Affiliations
  • 1Department of Orthopedic Surgery, Sung-Ae Hospital, Seoul, Korea. arcseo@hanmail.net

Abstract

PURPOSE
To investigate the influence of the size of low intensity zone (LIZ) (T1 image) on the vertebral body and the increase in the compression rate in patients with osteoporotic vertebral compression fracture.
MATERIALS AND METHODS
In a retrospective study, 187 patients (198 segments) who were followed-up for at least 3 months and diagnosed with thoracolumbar vertebral compression fracture between October 2011 and October 2016, and treated with conservative therapies, such as bed rest and thoraco-lumbar-sacral orthosis. We measured the size of the vertebral LIZ, and fractures on the upper and lower endplates were observed on the initial magnetic resonance imaging. We analyzed the correlation with the increase in compression rate at the last follow-up. Comparisons of the increase in the compression rate were analyzed through a correlation analysis.
RESULTS
The larger the size of the LIZ the greater the difference in the increase of the compression rate. The group with the initially LIZ (80%-100%) was significantly increased to 23.87%±17.90% (p=0.007). In case of fracture of upper and lower endplates, an increase in the compression rate was 19.39%±12.59% in the upper endplate fracture, which was significantly higher than that in the absence of endplate fracture (p=0.002).
CONCLUSION
The larger the size of the LIZ (T1 image) and superior endplate fracture observed on the initial magnetic resonance imaging after fracture, the greater the increase in the compression rate. In particular, when the size of the LIZ is greater than 80%, the compression rate was significantly increased.

Keyword

osteoporosis; compression fracture; compression rate

MeSH Terms

Bed Rest
Follow-Up Studies
Fractures, Compression*
Humans
Magnetic Resonance Imaging*
Orthotic Devices
Osteoporosis
Retrospective Studies

Figure

  • Figure 1 Measurement methods for cavity on T1 weighted magnetic resonance imaging. Cavity=B/A×100 (%).

  • Figure 2 Measurement methods for compression rate on simple x-ray. Compression rate=b/(a+c)/2×100 (%)

  • Figure 3 Sagittal image of the T1 magnetic resonance imaging according to the size of the low intensity zone (LIZ). From grades 1 of the left side to 5.

  • Figure 4 Magnetic resonance imaging T1 sagittal image. (A) Superior end plate disruption. (B) Inferior end plate disruption. (C) Both end plate disruptions.

  • Figure 5 Tendency to increase the around of change in compression rate depending on the size of the initial low intensity zone size.


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