MRI findings after successful vertebroplasty.
OBJECTIVE
Recurrent or residual back pain after vertebroplasty (VP) is common, and many patients with these symptoms are evaluated by MRI. The purpose of this report is to describe post-treatment MRI findings after successful VP.


METHODS
We identified all patients who underwent VP at our institution and later presented with back pain and had a spine MRI. From these patients, we identified a cohort with uncomplicated procedures, in whom back pain at the site of the VP was not the dominant pain source at follow-up. Using the pre- and postoperative MRIs and the VP conventional radiographs, we assessed such features as interval height loss and changes in marrow edema in treated vertebrae.


RESULTS
Thirty patients (51 treated vertebrae) met our clinical criteria for uncomplicated VP. Nine (18%) of 51 vertebrae lost additional height after the procedure. Neither patient demographics nor variables associated with the procedure itself, including volume of cement injected, correlated with additional height loss after VP. Moderate or severe marrow edema was demonstrated in 62% of vertebrae on preoperative MRI and in 33% of vertebrae on follow-up MRI. Twenty-one percent of vertebrae had new areas of marrow edema on follow-up. Twenty-two percent of vertebrae imaged >6 months after VP had moderate or severe edema.


CONCLUSIONS
Progressive and persistent edema and interval height loss after successful VP are common and should not be interpreted as sufficient evidence of ongoing pathology at the treated vertebral level.
Dansie
David M
DM
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Luetmer
Patrick H
PH
Lane
John I
JI
Thielen
Kent R
KR
Wald
John T
JT
Kallmes
David F
DF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013131:Spine / Q000473:pathology* / Q000601:surgery*