Image Classification of Osteoporotic Vertebral Fracture with Endplate-disc Complex Injury

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2021 Feb 18

PMID 33596887

Citations 1

Authors

Shuai Zhang

Song Wang

Qing Wang

Jin Yang

Shuang Xu

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to use MRI and CT to observe osteoporosis vertebral fracture (OVF) combined with endplate-disc complex (EDC) injury and to classify the degree of EDC injury according to the changes in EDC signal intensity and morphology on the images.

Methods: We investigated the incidence of EDC injury, observed the morphology and signal intensity changes of EDC injury using MRI and CT, and graded the injuries from 0 to 4 according to their severity. We compared whether there were differences in the degree of EDC injury among different vertebral fractures, bone mineral density(BMD), and severity of vertebral fractures.

Results: A total of 479 patients were included in this study, of whom 321 had EDC injury adjacent to the fractured vertebral body. Among those, 158 cases were grade 0, 66 cases were grade 1, 72 cases were grade 2, 78 cases were grade 3, and 92 cases were grade 4. The degree of EDC injury associated with thoracolumbar vertebral fractures was more serious than that of EDC injuries associated with thoracic and lumbar vertebral body fractures. Vertebral fractures with severe osteoporosis were associated with more severe EDC injury. Additionally, the more severe the vertebral fracture, the more severe was the combined EDC injury.

Conclusion: This study found that the incidence rate of EDC injury reached 67.0%. Among patients with OVF, severe osteoporosis and severe fractures in the thoracolumbar segments were often associated with more severe EDC injury.

Citing Articles

A retrospective study on the efficacy and safety of bone cement in the treatment of endplate fractures.

Zhao Z, Deng L, Hua X, Liu H, Zhang H, Jia X Front Surg. 2022; 9:999406.

PMID: 36277290 PMC: 9585934. DOI: 10.3389/fsurg.2022.999406.

References

BERNICK S, Cailliet R . Vertebral end-plate changes with aging of human vertebrae. Spine (Phila Pa 1976). 1982; 7(2):97-102. DOI: 10.1097/00007632-198203000-00002. View

Moretti A, Gimigliano F, Di Pietro G, Gimigliano R, Iolascon G . Back pain-related disability and quality of life in patients affected by vertebral fractures: data from baseline characteristics of population enrolled in Denosumab In Real Practice (DIRP). Aging Clin Exp Res. 2015; 27 Suppl 1:S3-9. DOI: 10.1007/s40520-015-0428-y. View

Genant H, Wu C, van Kuijk C, Nevitt M . Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993; 8(9):1137-48. DOI: 10.1002/jbmr.5650080915. View

Boonen S, Dejaeger E, Vanderschueren D, Venken K, Bogaerts A, Verschueren S . Osteoporosis and osteoporotic fracture occurrence and prevention in the elderly: a geriatric perspective. Best Pract Res Clin Endocrinol Metab. 2008; 22(5):765-85. DOI: 10.1016/j.beem.2008.07.002. View

Fujiwara T, Akeda K, Yamada J, Kondo T, Sudo A . Endplate and intervertebral disc injuries in acute and single level osteoporotic vertebral fractures: is there any association with the process of bone healing?. BMC Musculoskelet Disord. 2019; 20(1):336. PMC: 6642561. DOI: 10.1186/s12891-019-2719-5. View

Sander A, Laurer H, Lehnert T, El Saman A, Eichler K, Vogl T . A clinically useful classification of traumatic intervertebral disk lesions. AJR Am J Roentgenol. 2013; 200(3):618-23. DOI: 10.2214/AJR.12.8748. View

Nogues X, Martinez-Laguna D . Update on osteoporosis treatment. Med Clin (Barc). 2017; 150(12):479-486. DOI: 10.1016/j.medcli.2017.10.019. View

Boeree N, Dove J . The selection of wires for sublaminar fixation. Spine (Phila Pa 1976). 1993; 18(4):497-503. View

Ortiz A, Bordia R . Injury to the vertebral endplate-disk complex associated with osteoporotic vertebral compression fractures. AJNR Am J Neuroradiol. 2010; 32(1):115-20. PMC: 7964944. DOI: 10.3174/ajnr.A2223. View

10.

Iolascon G, Moretti A, Toro G, Gimigliano F, Liguori S, Paoletta M . Pharmacological Therapy of Osteoporosis: What's New?. Clin Interv Aging. 2020; 15:485-491. PMC: 7105363. DOI: 10.2147/CIA.S242038. View

11.

Razek A, Mohamed Sherif F . Diagnostic accuracy of diffusion tensor imaging in differentiating malignant from benign compressed vertebrae. Neuroradiology. 2019; 61(11):1291-1296. DOI: 10.1007/s00234-019-02286-x. View

12.

Chen L, Xia W, Jiang Y, Cui L, Huang W, Wang W . Vertebral fracture in postmenopausal Chinese women: a population-based study. Osteoporos Int. 2017; 28(9):2583-2590. DOI: 10.1007/s00198-017-4085-1. View

13.

Black D, Arden N, Palermo L, Pearson J, Cummings S . Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1999; 14(5):821-8. DOI: 10.1359/jbmr.1999.14.5.821. View

14.

Takahashi S, Hoshino M, Takayama K, Iseki K, Sasaoka R, Tsujio T . Predicting delayed union in osteoporotic vertebral fractures with consecutive magnetic resonance imaging in the acute phase: a multicenter cohort study. Osteoporos Int. 2016; 27(12):3567-3575. DOI: 10.1007/s00198-016-3687-3. View

15.

Moretti A, de Sire A, Curci C, Toro G, Gimigliano F, Iolascon G . Effectiveness of denosumab on back pain-related disability and quality-of-life in patients with vertebral fragility fractures. Curr Med Res Opin. 2018; 35(1):151-155. DOI: 10.1080/03007995.2018.1545636. View

16.

Prather H, Hunt D, Watson J, Gilula L . Conservative care for patients with osteoporotic vertebral compression fractures. Phys Med Rehabil Clin N Am. 2007; 18(3):577-91, xi. DOI: 10.1016/j.pmr.2007.05.008. View

17.

Lane N . Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol. 2006; 194(2 Suppl):S3-11. DOI: 10.1016/j.ajog.2005.08.047. View

18.

Li Q, Xiao L, Zhang J, Fan J, Zhou W, Yin G . The impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity during treatment of osteoporotic vertebral compression fractures with balloon kyphoplasty. J Biomed Res. 2016; 30(5):419-426. PMC: 5044714. DOI: 10.7555/JBR.30.20150071. View

19.

Lin R, Panjabi M, Oxland T . Functional radiographs of acute thoracolumbar burst fractures. A biomechanical study. Spine (Phila Pa 1976). 1993; 18(16):2431-7. DOI: 10.1097/00007632-199312000-00011. View

20.

Lieberman I, Dudeney S, Reinhardt M, Bell G . Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976). 2001; 26(14):1631-8. DOI: 10.1097/00007632-200107150-00026. View