2009 Fiscal Year Final Research Report
Predictors of treatment effect and subsequent fracture after percutaneous vertebroplasty
| Project/Area Number |
19790879
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Radiation science
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| Research Institution | Kyushu University |
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Principal Investigator |
HIWATASHI Akio Kyushu University, 医学研究院, 助教 (30444855)
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| Project Period (FY) |
2007 – 2009
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| 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 |
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| 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.
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