Value of immediate preprocedure magnetic resonance imaging in patients scheduled to undergo vertebroplasty or kyphoplasty.
METHODS
Retrospective case series.


OBJECTIVE
To determine the incidence of additional vertebral compression fractures diagnosed with repeat MRI immediately before vertebroplasty or kyphoplasty.


BACKGROUND
Vertebral compression fractures, which occur frequently in the elderly, are more likely in patients with prior vertebral compression fracture. When patients are evaluated for vertebroplasty, it is important to identify all unhealed fractures for effective treatment planning.


METHODS
In a retrospective study, we reviewed the records of all patients (n = 194) treated with vertebroplasty or kyphoplasty over a 6-year period at our institution, and identified all patients who had undergone a repeat MRI within 7 days of vertebroplasty or kyphoplasty. These studies were obtained as part of a clinical protocol prescribing a repeat MRI for any patient whose MRI had been obtained more than 3 months before the evaluation, or who had a change in their pain between referral and evaluation.


RESULTS
Twenty patients met inclusion criteria for the immediate preprocedure MRI protocol. A total of 14 new fractures in 11 patients were discovered on the immediate preprocedure MRI. Of these 14, 6 had less than 15% loss of height, making them potentially occult on radiographs; 3 fractures developed in 2 patients who had no change in back pain.


CONCLUSIONS
In select candidates for vertebroplasty or kyphoplasty, a repeat preprocedure MRI obtained within 1 week can help ensure that all painful fractures are treated. There is demonstrable value in this protocol for patients with an imaging evaluation over 3 months old or who have had any change in symptoms since the initial imaging workup.
Benz
Becky K
BK
Department of Radiology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.
Gemery
John M
JM
McIntyre
John J
JJ
Eskey
Clifford J
CJ
D000368:Aged; D001416:Back Pain / Q000473:pathology / Q000601:surgery; D017102:Fracture Healing; D050815:Fractures, Compression / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D011300:Preoperative Care; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D054854:Vertebroplasty