The Usefulness of Bone Scan in the Osteoporotic Vertebral Compression Fracture Patients Treated With Kyphoplasty

Deuk Soo Jun; Won Ju Shin; Kwang Hui Kim

doi:10.4184/jkss.2008.15.1.18

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Jun, Shin, and Kim: The Usefulness of Bone Scan in the Osteoporotic Vertebral Compression Fracture Patients Treated With Kyphoplasty

Original Article

Journal of Korean Spine Surg 2008;15(1):18-22.

Published online: 12 February 2008

DOI: https://doi.org/10.4184/jkss.2008.15.1.18

The Usefulness of Bone Scan in the Osteoporotic Vertebral Compression Fracture Patients Treated With Kyphoplasty

Deuk Soo Jun, M.D., Won Ju Shin, M.D., Kwang Hui Kim, M.D.

Department of Orthopedic Surgery, Gil Medical Center, Gacheon Medical University

Address reprint requests to Won-Ju Shin, M.D. Department of Orthopedic Surgery, Gil Medical Center, Gacheon Medical University. 1198, Kuwol-dong, Namdong-gu, Incheon, Korea. Tel: 82-32-460-3384, Fax: 82-32-468-5437, E-mail: shinwj72@gilhospital.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective study.

Objectives

To compare the clinical results of kyphoplasty between osteoporotic patients with compression fractures and rib hot uptake on bone scan and patients without rib hot uptake.

Summary of Literature Review

The incidence of osteoporotic rib fractures is 0.3% in postmenopausal women.

Materials and Methods

Between July 2005 and July 2006, 72 kyphoplasties for osteoporotic vertebral compression fractures were performed, and all patients had a bone scan study. On bone scan study, 41 patients (57.7%) had hot uptake in their ribs. Results were assessed by visual analog scale (VAS).

Results

The incidence of hot uptake was 67.8% in thoracic fractures, 40.0% in lumbar fractures, and 72.7% in thoracolumbar fractures. Hot uptake was significantly more common with thoracic and thoracolumbar fractures than with lumbar fractures (p<0.05). The incidence of hot uptake was 49.1% in one- and two-level fractures and 84.6% in over three-level fractures. This finding demonstrated significant difference between the two groups (p®0.05). The mean VAS scores for all cases were 8.2/3.4/3.2 at preoperative/immediate postoperative/after 3 months, respectively. In thoracic fractures, they were 8.2/3.9/3.1; lumbar fractures 8.0/3.2/3.1; and thoracolumbar fractures 8.3/3.7/3.0, respectively. The immediate postoperative VAS score in lumbar fractures was better than in thoracic fractures (p®0.05). The VAS scores in thoracic fractures with hot uptake were 8.3/4.1/3, and those without hot uptake were 7.8/2.8/3.0. The immediate VAS score in thoracic fractures without hot uptake was better than in those with hot uptake (p®0.05).

Conclusions

Thoracic and multiple osteoporotic compression fractures are often accompanied by rib fractures. Bone scan is a useful tool to detect rib fractures and predict the prognosis of kyphoplasty.

Keywords: Rib fracture, Compression fracture, Bone scan, Kyphoplasty

REFERENCES

1). Delmas PD. Treatment of postmenopausal osteoporosis. Lancet. 2002; 359:2018–2026.

2). Carolyn Becker. Clinical evaluation for osteoporosis. Clin Geriatr Med. 2003; 19:299–320.

3). Deng HW, Chen WM, Recker S, et al. Genetic determination of Colles' fracture and differential bone mass in women with and without Colles' fracture. J Bone Miner Res. 2000; 15:1243–1252.

4). Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001; 285:320–323.

5). Melton III LJ, Atkinson EJ, Cooper C, O'Fallon WM. Rigg BL. Vertebral fractures predict subsequent fractures. Osteoporos Int. 1999; 10:214–221.

6). Rho SM, Jung JY, Yoon TL, Lee JJ. An epidemiological study of hip fracture A comparison between 1991 and 2001. Korean Journal of Bone Metabolism. 2003; 10:109.

7). Chakravarty D, Sloan J, Brenchley J. Risk reduction through skeletal scintigraphy as a screening tool in suspected scaphoid fracture. Emerg Med J. 2002; 19:507–509.

8). Donohoe KJ, Henkin RE, Royal HD, et al. Procedure guideline for bone scintigraphy. J Nucl Med. 1999; 37:1903–1906.

9). Phillips FM. Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine. 2003; 28:45–53.

10). Ryu KS, Park CK, Kim MC, Kang JK. Dose dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fracture. J Neurosurg Spine. 2002; 96:56–61.

11). Diamond TH, Champion B, Clark WA. Management of Acute Osteoporotic Vertebral Fractures: A Nonrandom-ized Trial Comparing Percutaneous Vertebroplasty with Conservative Therapy. The American Journal of Medicine. 2003; 114:257–265.

12). Kelsey JL, Keegan TH, Prill MM, Quesenberry CP, Sidney S. Risk factors for fracture of the shafts of the tibia and fibula in older individuals. Osteoporos Int. 2006; 17:143–149.

13). James Roberts. Clinical Procedures in Emergency Medicine. 4th ed. Saunders: Elsevier;p. 1231. 2004.

Fig. 1.

66 years old female patient who slipped down one month ago has back pain. (A) T1 and T2-weighted MRI film demonstrate signal change at T8 vertebral body. (B) Bone scan demonstrates hot uptake at thoracic vertebra. (C) Post kyphoplasty radiographs demonstrate the cement augmentation at vertebral body.

Fig. 2.

75 years old female patient who slipped down 3 weeks ago has pain on back and left chest. (A) T1 and T2-weighted MRI film demonstrate signal change at T11 vertebral body. (B) Bone scan demonstrates hot uptake at thoracic vertebra and left side multiple ribs. (C) Post kyphoplasty radiographs demonstrate the cement augmentation at vertebral body.

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