BACKGROUND: Osteoporotic vertebral fractures are the most common complication in patients with osteoporosis. As a new imaging technique, spine magnetic resonance imaging (MRI) is much more sensitive than X-ray film in the diagnosis of osteoporotic vertebral fractures. However, total spine MRI is costly and takes a long time to scan. Therefore, there is no consensus on whether all patients with osteoporotic vertebral fractures need to undergo total spine MRI scan and which patients need to undergo total spine MRI.
OBJECTIVE: To analyze the distribution characteristics of vertebral fractures and explore their clinical significance by observing the whole spine MRI data of osteoporotic vertebral fractures patients.
METHODS: Data of cases and MRI images of all patients diagnosed with fresh osteoporotic vertebral fractures who visited the Department of Orthopedics, Affiliated Hospital of Southwest Medical University from August 2018 to September 2022 were retrospectively analyzed. 903 patients were included in the study based on inclusion and exclusion criteria. General information (age, gender, and body mass index), medical history characteristics (duration of illness, history of trauma surgery, percussion pain area, and pain score) were collected. The characteristics of vertebral fractures were analyzed through whole spine magnetic resonance imaging. Firstly, based on the number of vertebral fractures in patients, they were divided into the single vertebral fracture group (484 cases) and the multi-vertebral fracture group (419 cases), and the differences were analyzed between the two groups. Then, based on whether the farthest interval between the fractured vertebrae was greater than or equal to 5, the multi vertebral fracture group was further divided into two subgroups. Among them, Group A (the farthest interval between the fractured vertebrae was less than 5) contained 306 cases; Group B (with the farthest interval between fractured vertebral bodies greater than 5) included 113 cases. The differences were analyzed between two subgroups.
RESULTS AND CONCLUSION: (1) Among 903 patients, 419 patients (46.4%) had more than two fractured vertebrae. There were 654 patients (72.4%) with thoracolumbar fractures, and 54 patients (6%) with fractures in the thoracic plus lumbar region and the entire thoracic to lumbar region. In group B, 96.5% of patients had multiregional percussion pain. (2) Compared with the patients in the single vertebral fracture group and the multi-vertebral fracture group, there were significant differences in bone mineral density, whether the medical history was greater than or equal to 1 month, the history of low energy injury, and the distribution and number of axial percussion pain areas in the spine during physical examination between the two groups (P < 0.05). Age, gender, body mass index, whether there was underlying disease, pain visual analog scale score, whether there was a history of elderly thoracolumbar fracture, and whether there was a history of thoracolumbar surgery, and the number of fractured vertebrae had no statistical significance (P > 0.05). (3) There were statistically significant differences between the Groups A and B in bone mineral density, the distribution and quantity of percussion pain area, and the history of low energy injury
(P < 0.05). There were no significant differences in age, gender, history of old fractures, visual analog scale score, body mass index, whether the medical history was longer than or equal to 1 month, history of underlying diseases, and history of thoracolumbar surgery between the two groups (P > 0.05). (4) Patients with multiple low-energy trauma history, history of more than 1 month, multiple percussion pain, and the lower bone mineral density should be alert to the occurrence of multiple vertebral fracture and jump fracture. We recommend the whole spinal MRI for these patients.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程