title: The impact of preoperative magnetic resonance images on outcome of cemented vertebrae.
abstract: Refracture of cemented vertebrae is often seen after percutaneous vertebroplasty. The purpose of this prospective study was to evaluate pre-procedural magnetic resonance images (MRI) for the prediction of further collapse and vertebral height loss after vertebroplasty. This study included 81 consecutive patients (73 women and 8 men) with osteoporotic compression fractures. MR studies were performed 1-5 days before vertebroplasty. Patients were followed to evaluate refracture for a minimum of 6 months after treatment. Cox proportional hazards model was used to evaluate relationships between clinical data, covariates on pre-procedural MRI, and the presence of cemented vertebrae refracture. The mean refracture rate was estimated with the Kaplan-Meier method. After a mean follow-up of 23.0 ± 8.2 months, 46 cemented vertebrae (57%) experienced refracture, and the mean loss of anterior vertebral height was 11.3%. The 1-year refracture rate after vertebroplasty was 7%, and rapid increased to 76% in the third year. Cox proportional analysis showed that any 1% decrease in signal intensity on T2-weighted images of the injured vertebra will increase the refracture rate by 0.74% (OR = 0.26, 95% CI 0.08-0.81, p = 0.02), and a 1% increase in the poorly enhanced volume ratio will increase the refracture rate by 4.3% (OR = 5.32, 95% CI 1.22-23.14, p = 0.03). Quantitative pre-procedural MRI appears to be useful in exploring vertebrae with poor bone marrow integrity, which effectively predicts the subsequent refracture of cemented vertebra.
authors.affiliation: Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung 83305, Taiwan.
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lin
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Hung-Chen
authors.initials: HC
authors.lastname: Wang
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Yu
authors.forename: Re-Wen
authors.initials: RW
authors.lastname: Wu
authors.forename: Yu-Fan
authors.initials: YF
authors.lastname: Cheng
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012008:Recurrence; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements