![]() ![]() ![]() Superior endplate injury was more common either as an isolated event in 82 levels (39%) or in combination with inferior endplate injury in another 62 levels (total superior endplate injury = 68%) ( Figs 1 – 3). Vertebral endplate injury, as evidenced by the presence of endplate edema or fluid collection, cortical discontinuity or angulation, or intrusion of disk material into the endplate, was observed in 169 of the 211 levels studied (80%) ( Table). One hundred two OVCFs were located in the thoracic spine, and 109 OVCFs were located in the lumbar spine. All studies were interpreted by board-certified radiologists ( n = 21), most of whom were subspecialty trained in neuroradiology 3 or musculoskeletal radiology. They were also subsequently compared with the official written radiology reports of this patient group. These findings were recorded for each fracture level and the adjacent intervertebral disk. Disk injury was identified by the presence of disk edema or morphologic alteration compared with adjacent levels. This group of patients did not undergo concomitant CT spine imaging. Endplate injury was determined by the presence of endplate edema or fluid collection, cortical discontinuity or angulation, or intrusion of disk material into the endplate. All of these patients presented within 3 weeks to 3 months of onset of severe back pain that was not responsive to conservative management. One-half of these patients also had sagittal inversion-recovery sequences available for analysis.Ī total of 211 acute or subacute vertebral compression fractures, as determined by a combination of clinical presentation and the presence of marrow edema on T2-weighted and/or inversion-recovery sequences, were identified in this patient sample. The sequences that were analyzed included T1-weighted and fast spin-echo T2-weighted sagittal and axial images. Some patients underwent spine MR imaging on low-field open magnets at 0.6T, while most patients ( n = 75) underwent studies on 1.5T units. Their spine MR imaging examinations were performed on different MR imaging scanners in inpatient and outpatient settings. Eighty-eight patients were women, and 18 were men. The patients ranged from 40 to 94 years of age, with a mean age of 79.4 years. The MR imaging examinations of the thoracic and/or lumbar spine were reviewed by an experienced neuroradiologist in 106 patients who were evaluated for severe back pain and who subsequently were found to have ≥1 OVCF. Institutional review board approval was obtained for this study. It is our firm belief that a better understanding of the structural damage that occurs during osteoporotic vertebral collapse will not only result in the improvement of treatment techniques but may also add to our knowledge of other posttreatment challenges such as persistence of back pain symptoms or adjacent-level fractures. We sought to determine the frequency with which these structures are damaged as evidenced by the same imaging technique that is used to determine acute or subacute vertebral body injury. The purpose of this study was to evaluate 2 other prominent anterior column components of the spinal column, the vertebral endplate and the intervertebral disk. An axial load significant enough to damage the vertebral body could certainly be associated with enough force to cause damage to ≥1 of these aforementioned structures in what is already a compromised spinal column. Scant attention has been given to other spinal structures such as the vertebral endplate, the intervertebral disk, the posterior elements and facet joints, the spinal ligaments, and the paraspinal musculature. 2 A major emphasis has been placed on trying to identify edema or fluid clefts within the vertebral body. Procedures such as vertebroplasty and kyphoplasty provide significant pain relief following stabilization of the fractured vertebra. 1 Patients with symptomatic acute or subacute osteoporotic vertebral compression fractures are often considered potential candidates for treatment with vertebral augmentation procedures. MR imaging of the spine cannot only identify these vertebral compression deformities but also give a relative estimate of fracture acuity by detecting the presence of vertebral body marrow edema, especially on fluid-sensitive sequences such as inversion-recovery and T2-weighted sequences. OVCF of the thoracic and lumbar spine can be a source of disabling back pain. Abbreviations OVCF osteoporotic vertebral compression fracture ![]()
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