The Application of SPECT in the Diagnosis of Osteoporotic Vertebral Compression Fractures

Abstract

Objective: The aim of this study is to investigate the feasibility and effectiveness of single photon emission computed tomography (SPECT) as a replacement of magnetic resonance imaging (MRI) in the diagnosis of osteoporotic vertebral compression fractures (OVCF) under special situation. Methods: A total case of 43 vertebral compression fractures treated with percutaneous kyphoplasty (PKP) in 35 patients from Feb 10th, 2014 to Jan 12th, 2016 were collected. These patients, including 13 cases implanted with contraceptive ring, 14 cases implanted with steel plate and 8 cases implanted with metal stent, were diagnosed by SPECT but not MRI. The balloon was embedded into the vertebral body from the pedicle to reset the fractured vertebral body. PMMA was then filled into the balloon-produced space. The feasibility and effectiveness of SPECT were evaluated by observing reduction of fracture and postoperative pain symptoms. Results: The mean follow-up was 19.3 ± 2.7 months (ranged from 15 to 24 months). All patients were diagnosed by SPECT preoperatively. The preoperative mean loss of anterior and mid vertebral body heights were (13.2 ± 4.1) mm and (11.7 ± 4.0) mm, respectively, and the postoperative (48 h) mean loss were (4.7 ± 2.4) mm and (4.2 ± 2.0) mm, respectively. The mean kyphosis angle was improved from (22.9° ± 8.5°) to (9.4° ± 2.9°).The mean Visual Analogue Scale (VAS) decreased significantly from 8.4 ± 1.0 to 2.2 ± 1.0 in two days after operation. There are 2 cases of bone cement leakage occurred, including 1 case of leaking around the vertebral and 1 case of leaking into the disc. Conclusion: SPECT, as a replacement of MRI under special situation, can definitely diagnose painful vertebrae.