Predictors of treatment effect and subsequent fracture after percutaneous vertebroplasty

• Project/Area Number: 19790879
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Single-year Grants
• Research Field: Radiation science
• Research Institution: Kyushu University
• Principal Investigator: HIWATASHI Akio Kyushu University, 医学研究院, 助教 (30444855)
• Project Period (FY): 2007 – 2009
• Project Status: Completed (Fiscal Year 2009)
• Budget Amount: ¥3,780,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥480,000); Fiscal Year 2009: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2008: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2007: ¥1,700,000 (Direct Cost: ¥1,700,000)
• Keywords: 骨粗鬆症 / 椎体圧迫骨折 / 経皮的骨形成術 / 画像診断 / IVR / 神経放射線科学 / 骨粗霧症 / 神経放射線化学

Research Abstract

BACKGROUND AND PURPOSE : Subsequent fracture is often seen after percutaneous vertebroplasty. The purpose of this prospective study was to evaluate preoperative multi-detector row computed tomography (MDCT) for predicting subsequent fractures after vertebroplasty.
MATERIALS AND METHODS : This study included 26 consecutive patients (18 women and 8 men) with osteoporotic compression fractures (58 vertebrae). Sixty-four-slice MDCT with multiplanar reformation was obtained within a day before the procedure. Repeat magnetic resonance (MR) imaging was used to evaluate new fractures at least three months after treatment on a routine basis or if there was recurrent pain. We used logistic regression analysis with MDCT findings and clinical data for statistical evaluation according to the location of new fractures.
RESULTS : Subsequent fractures were noted at 14 adjacent vertebrae (12.1%) in 13 patients and at 14 remote vertebrae in 6 patients (23.1%). Subsequent fractures in adjacent vertebrae tended to occur in small vertebrae before treatment (P < .05). Steroid medication and low CT value in nonfractured vertebrae were associated with subsequent fractures in remote vertebrae (P < .05). Further collapse of the treated vertebral bodies was noted in 10 patients (11 vertebrae, 19.0 %) without specific findings (P > .05). CONCLUSION: The small size of the treated vertebrae may relate to subsequent fracturesin adjacent vertebrae. Steroid use and low CT value of nonfractured vertebrae on preoperative MDCT can be associated with subsequent fractures in remote vertebrae.

Research Products

• [Journal Article] 骨粗鬆症と圧迫骨折 (2009)
  • Author(s): 樋渡昭雄, 他4名
  • Journal Title: 臨床画像 25巻 Pages: 856-862
• [Journal Article] Subsequent fracture after percutaneous vertebroplasty can be predicted on preoperative multidetector row CT. (2009)
  • Author(s): Hiwatashi A, 他5名
  • Journal Title: AJNR Am J Neuroradiol. 30巻 Pages: 1830-1834
  • Peer Reviewed
• [Journal Article] Kyphoplasty and vertebroplasty produce the same degree of height restoration. (2009)
  • Author(s): Hiwatashi A, 他7名
  • Journal Title: AJNR Am J Neuroradiol. 30巻 Pages: 669-673
  • Peer Reviewed
• [Journal Article] Early subsequent fracture after percutaneous vertebroplasty proven by magnetic resonance imaging. (2009)
  • Author(s): Tashima Y、Hiwatashi A, 他5名
  • Journal Title: Eur J Radiol extra 68巻
  • Peer Reviewed
• [Journal Article] Kyphoplasty and vertebroplasty produce the same degree of height restoration. (2009)
  • Author(s): Hiwatashi A, 他7名
  • Journal Title: AJNR Am J Neuroradiol 30 Pages: 669-673
  • Peer Reviewed
• [Journal Article] Subsequent fracture after percutaneous vertebroplasty can be predicted on preoperative multidetector row CT (2009)
  • Author(s): Hiwatashi A, 他5名
  • Journal Title: AJNR Am J Neuroradiol 30 Pages: 1830-1834
  • Peer Reviewed
• [Journal Article] 骨粗鬆症と圧迫骨折 (2009)
  • Author(s): 樋渡昭雄, 他4名
  • Journal Title: 臨床画像 25 Pages: 856-862
  • Peer Reviewed
• [Journal Article] Kyphoplasty and Vertebroplasty Produce the Same Degree of Height Restoration (2009)
  • Author(s): Hiwatashi A、他7名
  • Journal Title: AJNR Am J Neuroradiol 30
  • Peer Reviewed
• [Journal Article] Usefulness of cone-beam CT before and after percutaneous vertebroplasty. (2008)
  • Author(s): Hiwatashi A, 他6名
  • Journal Title: AJR Am J Roentgenol 191 Pages: 14101-1405
  • Peer Reviewed
• [Journal Article] { HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/18941077?ordinalpos=l&itool=Entre zSystem2.PEntrez.Pubmed.Pubmed_ResuitsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum"} (2008)
  • Author(s): Hiwatashi A、他6名
  • Journal Title: AJR Am J Roentgenol 191 Pages: 1401-1405
  • Peer Reviewed
• [Journal Article] Early subsequent fracture after percutaneous vertebroplasty proven by magnetic resonance imaging (2008)
  • Author(s): Tashima Y、Hiwatashi A、他5名
  • Journal Title: Eur J Radiol extra 68
  • Peer Reviewed
• [Journal Article] 経皮的椎体形成術-脊椎圧迫骨折の早期疼痛緩和を目指して- (2007)
  • Author(s): 樋渡昭雄, 他5名
  • Journal Title: 福岡医学雑誌 98巻 Pages: 337-345
  • NAID: 120000987978
  • Peer Reviewed
• [Journal Article] 経皮的椎体形成術-脊椎圧迫骨折の早期痙痛緩和を目指して- (2007)
  • Author(s): 樋渡昭雄, 他5名
  • Journal Title: 福岡医学雑誌 98 Pages: 337-345
  • Peer Reviewed
• [Presentation] 経皮的椎体形成術:術後MDCT所見とUTE-MRIの検討 (2010)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第39回日本神経放射線学会
  • Place of Presentation: 東京
  • Year and Date: 2010-11-13
• [Presentation] 防的経皮的椎体形成術を行った椎体に新たな骨折を認めた1例 (2009)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第169回日本医学放射線学会九州地方会
  • Place of Presentation: 福岡市
• [Presentation] Subsequent fracture after percutaneous vertebroplasty can be predicted on preoperative multidetector row CT. (2009)
  • Author(s): Hiwatashi A, 他5名
  • Organizer: ASNR 47th Annual Meeting
  • Place of Presentation: バンクーバー、カナダ
• [Presentation] 経皮的椎体形成術:続発性骨折と術前MDCT所見の検討 (2009)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第68回日本医学放射線学会学術集会
  • Place of Presentation: 横浜市
• [Presentation] 経皮的椎体形成術:続発性骨折と術直後MDCT所見の検討 (2009)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第38回日本神経放射線学会
  • Place of Presentation: 水戸市
• [Presentation] Subsequent fracture after percutaneous vertebroplasty can be predicted on preoperative multidetector row CT (2009)
  • Author(s): Hiwatashi A, 他5名
  • Organizer: ASNR 47th Annual Meeting
  • Place of Presentation: バンクーバー、カナダ
• [Presentation] 予防的経皮的椎体形成術を行った椎体に新たな骨折を認めた1例 (2009)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第169回日本医学放射線学会九州地方会
  • Place of Presentation: 福岡市
• [Presentation] 経皮的椎体形成術 : 続発性骨折と術直後MDCT所見の検討 (2009)
  • Author(s): 樋渡昭雄、他x名
  • Organizer: 第38回日本神経放射線学会
  • Place of Presentation: 水戸市
• [Presentation] 経皮的椎体形成術前及び術後の形態評価:MDCTとCone-beam CTとの比較 (2008)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第4回椎体形成術研究会
  • Place of Presentation: 京都市
  • Year and Date: 2008-08-23
• [Presentation] 経皮的椎体形成術前及び術後の形態評価 : MDCTとCone-beam CTとの比較 (2008)
  • Author(s): 樋渡昭雄
  • Organizer: 第4回椎体形成術研究会
  • Place of Presentation: 京都市
  • Year and Date: 2008-08-23
• [Presentation] Kyphoplasty vs. Vertebroplasty:形態変化およびセメント漏出の検討 (2008)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第67回日本医学放射線学会学術集会
  • Place of Presentation: 横浜市
• [Presentation] 経皮的椎体形成術前及び術後の形態評価:MDCTとCone-beam CTとの比較 (2008)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第37回日本神経放射線学会
  • Place of Presentation: 横浜市
• [Presentation] Kyphopiasty vs.Vertebroplasty : 形態変化およびセメント漏出の検討 (2008)
  • Author(s): 樋渡昭雄、他5名
  • Organizer: 第67回日本医学放射線学会学術集会
  • Place of Presentation: 横浜市
• [Presentation] 経皮的椎体形成術前及び術後の形態評価:MDCrとCone-beam CTとの比較 (2008)
  • Author(s): 樋渡昭雄, 他5名
  • Organizer: 第37回日本神経放射線学会
  • Place of Presentation: 横浜市
• [Presentation] 経皮的椎体形成術後早期に新規骨折を生じた一例 (2007)
  • Author(s): 田島歓子、樋渡昭雄, 他5名
  • Organizer: 第165回日本医学放射線学会九州地方会
  • Place of Presentation: 熊本市