The Evaluation of Different Radiological Measurement Parameters of the Degree of Collapse of the Vertebral Body in Vertebral Compression Fractures.

Wei-En Hsu,Kun-Hui Chen,Kuo-Chih Su,Cheng-Hung Lee,Chien-Chou Pan,Wen-Hsien Lu

doi:10.1155/2019/4021640

Wei-En Hsu, Kun-Hui Chen + Show 4 more

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https://doi.org/10.1155/2019/4021640

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Abstract

For compression fracture, vertebral body height loss (VBHL) and kyphotic angle (KA) are two important imaging parameters for determining the prognosis and appropriate treatment. This study used previous measurement methods to assess the degree of VBHL and KA, compare and examine differences between various measurement methods, and examine the correlation between relevant measurement parameters and intravertebral cleft (IVC) in the vertebral body. The radiographic images (lateral view of the T-L spine) of 18 patients with a single-level vertebral compression fracture were reviewed. We measured 9 characteristic lengths and angles on plain radiographs, including anterior vertebral height (AVH) and AVH of the adjacent upper and lower levels, middle vertebral height (MVH) and MVH of the adjacent upper and lower levels, posterior vertebral height (PVH), and vertebral body width, and assessed 6 parameters, including vertebral compression ratio (VBCR), percentage of anterior height compression (PAHC), percentage of middle height compression (PMHC), kyphotic angle (KA), calculated kyphotic angle (CKA), and IVC. The results showed that VBCR is a simple and rapid method of VBHL assessment, but it may result in an underestimation of the degree of VBHL compared to PAHC. When PMHC < 40% or kyphotic angle > 15°, the probability of IVC occurring on the vertebral body was higher which means the higher risk of vertebral body instability. The results of this study could provide a reference for surgeons when using imaging modalities to assess the degree of vertebral body collapse.

Highlights

As the population ages, the prevalence of osteoporosis gradually increases, and the resulting medical cost increases every year
The marker results show that the vertebral compression ratio (VBCR) are greater than the percentage of anterior height compression (PAHC), with differences ranging from −2.5% to 27.74%
VBCR, PAHC, and kyphotic angle (KA) were based on assessment methods in previous studies, while percentage of middle height compression (PMHC) and calculated kyphotic angle (CKA) are new parameters examined in this study

Summary

Introduction

The prevalence of osteoporosis gradually increases, and the resulting medical cost increases every year. Vertebral compression fracture is one of the important complications of osteoporosis [1, 2]. Radiography is the most widely used tool for the diagnosis and assessment of compression fractures. Vertebral body height loss (VBHL) and kyphotic angle (KA) are two important imaging parameters for determining the prognosis and appropriate treatment [3]. The degrees of collapse of the vertebral body may affect the direction of treatment (nonsurgical management, like rest, bracing, and pain control drug, or surgery, like vertebra augmentation, instrumentation, or fusion). Data have shown that a KA of >15°–30° or height loss of >50% resulted in vertebral body instability, which may require a more invasive treatment such as vertebral augmentation [4,5,6]

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