Sayed Abdullah Ahmadi1, Shinji Takahashi2, Masatoshi Hoshino1, Kazushi Takayama3, Ryuichi Sasaoka4, Tadao Tsujio5, Hiroyuki Yasuda6, Fumiaki Kanematsu7, Hiroshi Kono8, Hiromitsu Toyoda1, Hiroaki Nakamura1. 1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. 2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: shinji@med.osaka-cu.ac.jp. 3. Department of Orthopaedic Surgery, Seikeikai Hospital, Sakai, Osaka, Japan. 4. Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan. 5. Department of Orthopaedic Surgery, Shiraniwa Hospital, Ikoma, Nara, Japan. 6. Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan. 7. Department of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, Osaka, Japan. 8. Department of Orthopaedic Surgery, Ishikiri Seiki Hospital, Higashi Osaka, Osaka, Japan.
Abstract
BACKGROUND CONTEXT: Osteoprotic vertebral fractures (OVFs) are common in elderly people. The association between back pain due to OVF with magnetic resonance imaging (MRI) signal change is unclear. In this study we hypothesized that MRI findings would be a predictive factor for back pain measured by visual analogue scale (VAS) at 6 months follow-up. PURPOSE: The aim was to study the MRI findings that predict back pain after OVF and the association between radiological findings and scores of back pain. STUDY DESIGN: Multicenter prospective cohort study. PATIENT SAMPLE: A total of 153 OVF patients. OUTCOME MEASURE: The outcome measures were VAS back pain and MRI signal change. METHODS: This study was performed from 2012 to 2015. Consecutive patients with less than 2-week-old OVFs at 11 institutions were enrolled prospectively. MRI was performed at enrollment and at 1, 3, and 6 months follow-up. T1- and T2-weighted images (T1WI and T2W1) were obtained at each time point and their association with VAS scores of back pain at 6 months were investigated. Anterior compression ratio, posterior compression ratio, and angular motion of vertebral bodies were also measured on X-rays at each follow-up. This research had no financial support. There are no conflicts of interest. RESULT: The 6 months follow-up was completed by 153 patients. At enrollment, the average VAS score of back pain was 75 mm, and it had improved at the 6-month follow-up to an average score of 20 mm. There was a significant correlation between T1 diffuse low signal change and VAS scores at the 6-month follow-up (p<.01). T2 high signal changes (odds ratio; 4.01, p<.01) and old vertebral fractures (odds ratio; 2.47, p=.04) were independent risk factors for back pain. The correlation between angular motion of vertebrae on X-rays and the VAS score of back pain was significant at all time points. CONCLUSION: This study demonstrates the radiological factors associated with persistent back pain after an OVF and the association between the VAS score of back pain and radiological findings. In addition, T2 high signal changes in acute phase and old vertebral fractures were independent risk factors for residual back pain.
BACKGROUND CONTEXT: Osteoprotic vertebral fractures (OVFs) are common in elderly people. The association between back pain due to OVF with magnetic resonance imaging (MRI) signal change is unclear. In this study we hypothesized that MRI findings would be a predictive factor for back pain measured by visual analogue scale (VAS) at 6 months follow-up. PURPOSE: The aim was to study the MRI findings that predict back pain after OVF and the association between radiological findings and scores of back pain. STUDY DESIGN: Multicenter prospective cohort study. PATIENT SAMPLE: A total of 153 OVF patients. OUTCOME MEASURE: The outcome measures were VAS back pain and MRI signal change. METHODS: This study was performed from 2012 to 2015. Consecutive patients with less than 2-week-old OVFs at 11 institutions were enrolled prospectively. MRI was performed at enrollment and at 1, 3, and 6 months follow-up. T1- and T2-weighted images (T1WI and T2W1) were obtained at each time point and their association with VAS scores of back pain at 6 months were investigated. Anterior compression ratio, posterior compression ratio, and angular motion of vertebral bodies were also measured on X-rays at each follow-up. This research had no financial support. There are no conflicts of interest. RESULT: The 6 months follow-up was completed by 153 patients. At enrollment, the average VAS score of back pain was 75 mm, and it had improved at the 6-month follow-up to an average score of 20 mm. There was a significant correlation between T1 diffuse low signal change and VAS scores at the 6-month follow-up (p<.01). T2 high signal changes (odds ratio; 4.01, p<.01) and old vertebral fractures (odds ratio; 2.47, p=.04) were independent risk factors for back pain. The correlation between angular motion of vertebrae on X-rays and the VAS score of back pain was significant at all time points. CONCLUSION: This study demonstrates the radiological factors associated with persistent back pain after an OVF and the association between the VAS score of back pain and radiological findings. In addition, T2 high signal changes in acute phase and old vertebral fractures were independent risk factors for residual back pain.
Keywords:
Association between MRI; Back pain; MRI signal changes; Magnetic resonance imaging; Osteoporosis; Risk factors for persistent back pain; Vertebral fracture; X-ray and VAS score of back pain
Authors: W F Lems; J Paccou; J Zhang; N R Fuggle; M Chandran; N C Harvey; C Cooper; K Javaid; S Ferrari; K E Akesson Journal: Osteoporos Int Date: 2021-01-21 Impact factor: 4.507