Article Figures & Data
Figures
- Fig 1.
Extent of bone marrow edema (BME) in 89 treated vertebral compression fractures before the procedure (0 month) and at follow-up intervals after percutaneous vertebroplasty (PV) in 64 patients.
- Fig 2.
Sagittal short τ inversion recovery (STIR) (A) and T1-weighted image (B) follow-up in a patient with osteoporotic vertebral compression fracture (VCF) T12 treated by percutaneous vertebroplasty (PV). Visual analog score for pain before (0) and at 3, 6, and 12 months after PV: 10, 2, 1, and 1, respectively. Patient used morphine pre-procedure (0) and no pain medication at 3, 6, and 12 months after PV. Percentage bone marrow edema (based on all images) in VCF T12 before (0) and at 3, 6, and 12 months after PV: 75%, 25%, 20%, and 0%, respectively.
- Fig 3.
Small hyperintense rim on sagittal short τ inversion recovery (STIR) and hypointense on T1-weighted image, comparable with the signal intensity of water, directly surrounding the cement cast at 6-month follow-up after PV of VCF L1.
- Fig 4.
Median visual analog scale (VAS) score for pain in 31 patients (subgroup A) before percutaneous vertebroplasty (PV) and at follow-up intervals.
- Fig 5.
Use of analgesics in 31 patients (subgroup A) before percutaneous vertebroplasty (PV) and at follow-up intervals.
Tables
- Table 1:
Characteristics of patients with one treated vertebral compression fracture (VCF) and no new VCF or pain at another untreated level during follow-up (subgroup A) and the remaining patients (subgroup B)
Total Group Subgroup A Subgroup B P Value No of patients 64 31 33 Median age (y) (range) 70 (47–88) 70 (47–88) 70 (51–88) .5 Mean age (y) 69 68 70 Women (%) 49 (77) 24 (77) 8 (24) .9 No. of VCF treated by PV 89 31 59 - Median age in months of treated VCF (range) 4 (2–48) 4 (2–13) 4 (2–48) .3 Mean age 5.5 4.5 6.0 Extent bone marrow edema in treated VCF Minor (1%–24%) 6 6 5 Moderate (25%–74%) 27 26 28 .95 Severe (75%–100%) 67 68 67 Shape treated VCF (%) Wedge 61 68 57 Biconcave 39 32 43 .3 Grade treated VCF (%) Mild 28 26 29 Moderate 33 39 29 .7 Severe 39 35 41 Median injected cement volume (cc) (range) 3.0 (1.0–4.5) 3.0 (1.2–4.5) 2.6 (0.8–4.0) .01 Mean 2.6 3.0 2.4 Median initial VAS for pain (range) 9.0 (4–10) 8.0 (4–10) 10 (6–10) .02 Mean 8.7 8.2 9.1 Initial pain medication (%) No 11 13 9 Paracetamol 12 13 12 0.2 NSAID 28 39 18 Operative 49 35 61 Patients with multiple treated VCF (%) 19 (29) - 19 (58) - Patients with new VCF after PV (%) 17 (26) - 17 (52) - Patients with pain at another untreated level 7 (11) - 7 (21) - After PV, but without new VCF (%) Note: — PV indicates percutaneous vertebroplasty; VAS, visual analog score; NSAID, nonsteroid antiinflammatory drugs.
P values indicate differences in subgroups A and B.
- Table 2:
Relationship between changes in extent of bone marrow edema (BME) in treated vertebral compression fractures (VCF) and corresponding decreases in visual analog score (VAS) for pain and use of analgesics in the 3 follow-up intervals after percutaneous vertebroplasty (PV) in 31 patients (subgroup A)
Follow-up Interval after PV 0–3 mo 3–6 6–12 mo Change in BME extent No. of VCF with BME 31 20 17 Decrease 90% 45% 41% Similar 10% 55% 59% Increase — — — Mean decrease in VAS 6.1 0.3 0.2 Decrease 100% 19% 29% Similar — 71% 55% Increase — 10% 16% Change in analgesic use Decrease 82% 10% 7% Similar 18% 84% 87% Increase — 6% 6% - Table 3:
Relationship between changes in extent of bone marrow edema (BME) in treated vertebral compression fractures (VCF) and corresponding decreases in visual analog score (VAS) for pain and use of analgesics in the 3 follow-up intervals after percutaneous vertebroplasty (PV) in 31 patients (subgroup A)
Change in BME Extent Follow-up Interval after PV 0–3 mo 3–6 mo 6–12 mo Decrease Mean VAS Decrease Analgesic Use Decrease Mean VAS Decrease Analgesic Use Decrease Mean VAS Decrease Analgesic Use Decrease in BME 6.3 86% 0.4% 0% 0.7% 14% Similar BME 6.0 67% 0.2 15% 0.1 4% Regression coefficient 1.3 0.8 0.2 0.2 0.6 0.6 95% confidence interval −4.4–1.7 −2.0–0.5 −1.0–0.7 −0.9–0.8 −1.8–0.5 −1.8–0.5 BME absent 6.3 89% 0.2 14% 0.2 5% BME present 6.0 82% 0.3 6% 0.4 8% Regression coefficient 0.2 0.5 0.1 0.02 0.1 0.1 95% Confidence interval −1.9–2.2 −1.3–0.4 −0.9–0.07 −0.9–0.8 −1.1–0.9 −1.1–0.9
