MRI evaluation on the time and function prognosis of vertebral compression induced by spinal trauma or primary osteoporosis

Keguang FU; Jiangxi XIAO; Tinglin LI; Dongming HAN

ABSTRACT

BACKGROUND:

The bone fragments from spinal vertebral fracture can enter into vertebral canal to cause neural functional injury. The restoration of neural function after injury is mainly determined by the character and extent of primary injury, and is related with the spinal injured range. Early imageological analysis can evaluate the degree and range of spinal injury to preliminarily evaluate the therapeutic method and prognosis of the patient.

OBJECTIVE:

To explore the merit of MRI in the evaluation of function prognosis in compressive fracture induced by spinal trauma or primary osteoporosis to provide a gist for early rehabilitative intervention.

DESIGN:

A case retrospective study by employing patients with benign vertebral compressive fracture as subjects.

SETTING:

Department of Imageology of Henan Provincial Hebi Mineral Bureau General Hospital, Department of Radiology of affiliated hospitals of two universities.

PARTICIPANTS:

Totally 107 cases(123 vertebras) of benign vertebral compressive fracture with complete clinical data including 65 cases of trauma (trauma group, 71 vertebras) and 42 cases of osteoporosis(osteoporosis group, 52 vertebras) were selected from 125 spinal MRI testees of the first affiliated hospital of Beijing Medical University and the first affiliated hospital of Xinxiang Medical College for retrospective analysis.

INTERVENTIONS:

MRI images of the compressive vertebras in 107 cases (123 vertebras) induced by acute trauma or primary osteoporosis were comparatively analyzed by two vice botanic physicians with blindness method.Vertebral compression was classified into "wedge-shaped" or "flat-shaped" based on the difference between anterior and posterior height of the deformed vertebras and the shapes to observe whether there was bone fragment or not and typical fracture line.

RESULTS:

MRI manifestation of osteoporosis compression medullary signal was completely kept in the deformed vertebras with the mixture of high signals. The anterior superior angle of vertebra stuck into vertebral canal. Strip low signal was under the endplate of T1 vertebra. The anterior and posterior vertebral border had normal morphology or slightly sucked with smooth margin. Vertebral vein was clearly displayed. MRI manifestation of traumatic compression vertebra had relatively even low signal and kept partial medullary signals. Vertebra was obviously deformed with para-vertebral hematoma. There was fracture line or usually accompanied with medullary edema, and cystic degeneration. Vertebral enhancement was an important manifestation of fracture rehabilitative stage, which was the indicator for the judgment of fresh or old fracture.

CONCLUSION:

MRI can differentiate spinal traumatic fracture and primary osteoporosis fracture, judge fracture time, and preliminarily evaluate the function and prognosis of the patient.