| Title |
Clinical Outcomes, Magnetic Resonance Imaging Findings, and Risk Factors for Severe Vertebral Collapse in Conservative Treatment of Osteoporotic Vertebral Fractures |
| Subtitle |
Original Article |
| Authors |
Kazuma Nagao1,2, Keishi Maruo2,6, Tomoyuki Kusukawa2, Tetsuto Yamaura5, Masaru Hatano8, Masakazu Toi3, Yutaka Horinouchi4, Fumihiro Arizumi2, Kazuya Kishima2, Norichika Yoshie2,7, Toshiya Tachibana2 |
| Authors (kana) |
|
| Organization |
1Department of Orthopaedic Surgery, Takarazuka City Hospital, 2Department of Orthopaedic Surgery, Hyogo Medical University, 3Department of Orthopaedic Surgery, Miyoshi Hospital, 4Department of Orthopaedic Surgery, Hyogo Medical University Sasayama Medical Center, 5Department of Orthopaedic Surgery, Harima Hospital, 6Department of Orthopaedic Surgery, Goshi Hospital, 7Department of Orthopaedic Surgery, JCHO Osaka Minato Central Hospital, 8Department of Orthopaedic Surgery, Daiwa Central Hospital |
| Journal |
Journal of Spine Research
|
| Volume |
16
|
| Number |
2
|
| Page |
50-57 |
| Year/Month |
2025 / |
| Article |
Original article |
| Publisher |
The Japanese Society for Spine Surgery and Related Research |
| Abstract |
[Abstract] [Introduction :] The aim of this study was to examine the association between vertebral collapse and magnetic resonance imaging (MRI) signal changes and risk factors in osteoporotic vertebral fractures (OVF). [Methods :] A total of 103 patients met the inclusion criteria (age >= 60 years, single OVF, semi-quantitative [SQ] grade of 0-2 at baseline, and minimum follow-up >=1 year) with a mean age of 79.3+-7.1 years. The severe collapse group was defined as SQ grade 3 at 1-year follow-up. Patient characteristics and clinical outcomes (JOABPEQ, ODI and VAS) were compared between the severe collapse and noncollapse groups. Additionally, we evaluated bone marrow edema (BME) using MRI-STIR images at baseline, 3 months, and 1 year, categorizing it into four levels (none : 0%, minor : 1%-24%, moderate : 25%-74%, severe : 75%-100%) and comparing the two groups. [Results :] Severe collapse was observed in 39 cases (38%). There were no significant differences in patient characteristics between the two groups. Clinical outcomes showed significant improvement in VAS scores at 3 months and 1 year in both groups. No significant differences were found between the two groups in terms of JOABPEQ and ODI at baseline, 3 months and 1 year. The severe collapse group had a higher prevalence of confined high signal and diffuse low signal on T2-weighted images at baseline. Regarding BME, there was a significant difference at 3 months, with the severe collapse group having a 71% rate of severe BME compared with 34% in the noncollapse group. This difference was also significant at 1 year, with the severe collapse group at 5% for "none" compared with 50% in the noncollapse group. [Conclusions :] Severe vertebral collapse was observed in 38% of cases, but clinical outcomes significantly improved in both groups. In cases of noncollapse, half of them showed resolution of bone marrow edema on MRI, suggesting bone healing. |
| Practice |
Clinical surgery |
| Keywords |
osteoporotic vertebral fracture, vertebral collapse, conservative treatment |
