title: Relationship between clinical symptoms of osteoporotic vertebral fracture with intravertebral cleft and radiographic findings.
abstract: BACKGROUND
  With aging of the population, the numbers of osteoporotic vertebral fractures with intravertebral cleft have been increasing. However, the details of clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft are poorly understood. The purpose of this study was to evaluate the relationship between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings.
  
  
  METHODS
  Two hundred seventeen patients with single-level osteoporotic vertebral fractures with intravertebral cleft were examined. Clinical symptoms were evaluated using Numerical Rating Scale for back pain and the Oswestry Disability Index for physical disability. The presence of delayed neurologic deficit was also detected. Radiography and computed tomography were used to measure local kyphotic angle and vertebral instability and to detect the presence of posterior wall fracture of the vertebral body. Correlations between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings were investigated.
  
  
  RESULTS
  Mean Numerical Rating Scale and Oswestry Disability Index were 7.4 and 58.0%, respectively. Delayed neurologic deficit occurred in 41 patients (19%). The mean local kyphotic angle, vertebral instability, and rate of posterior wall fracture of the vertebral body were 19.4°, 7.3°, and 91%, respectively. Numerical Rating Scale and Oswestry Disability Index were statistically correlated with vertebral instability but not with local kyphotic angle and presence of posterior wall fracture. In the patients with delayed neurologic deficit, vertebral instability was significantly higher and posterior wall fractures were significantly more frequent than in the patients without delayed neurologic deficit. Local kyphotic angle was not correlated with delayed neurologic deficit.
  
  
  CONCLUSIONS
  Vertebral instability is a factor causing symptoms of osteoporotic vertebral fractures with intravertebral cleft. In addition, vertebral instability may be the predominant cause of delayed neurologic deficit. To manage osteoporotic vertebral fractures with intravertebral cleft and delayed neurologic deficit efficiently, it may be important to control vertebral instability of osteoporotic vertebral fractures.
authors.affiliation: Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan. Electronic address: toshinakamae623813@yahoo.co.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamae
authors.affiliation: Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hiramatsu
authors.affiliation: Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Muskuloskeletal Research, Department of Medical Chemistry and Cellbiology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Olmarker
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Adachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D010147:Pain Measurement; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*