Gerd Noeldge MD, PhD, Presenter: Nothing to Disclose

Ingo Grafe, Abstract Co-Author: Nothing to Disclose

Katharina Da Fonseca, Abstract Co-Author: Nothing to Disclose

Martin Libicher MD, Abstract Co-Author: Nothing to Disclose

Peter Jürgen Meeder, Abstract Co-Author: Nothing to Disclose

Christian Kasperk, Abstract Co-Author: Nothing to Disclose

Guenter W. Kauffmann MD, PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Kyphoplasty has been shown to be a safe and effective method for reducing pain in patients with painful osteoporotic vertebral fractures. In fractured vertebral bodies, bone edema detected by MRI are a radiological finding in acute fracture cases which is usually not discernable after 3 months. This study investigates the possibility that only patients with acute vertebral fractures as indicated by MR-detected bone edema benefit from kyphoplasty in terms of pain reduction.

Preoperative MR-Images are available from 35 patients with primary osteoporosis and painful vertebral fractures who were treated by kyphoplasty. MR-Images were evaluated with regard to the presence or absence of a bone edema. All patients received a pharmacological osteoporosis treatment (1000mg calcium, 1000IU vitamin D3, oral aminobisphosphonate), pain medication and physiotherapy. Pain (visual analog scale (VAS), range 0-100) and radiomorphological measures were assessed at baseline, after 1 and 12 months.

In 20 patients with MR-detected bone edema the pain score (VAS) changed from 23.4 (preoperative) to 55.8 (postoperative) and to 49.1 after 12 months. In 15 patients with no preoperative bone edema the pain score improved from 29.9 (preoperative) to 39,5 (postoperative) and to 50.9 after 12 months.

In patients with new vertebral fractures, confirmed by bone edema in MR-Images, kyphoplasty is an effective method for an immediate and sustained pain reduction. After 12 months there was a comparable pain reduction in patients with and without preoperative bone edema. We conclude that MR-detected bone edema is not a prerequisite for the long-term benefit of kyphoplasty in patients with painful osteoporotic vertebral fractures, provided that kyphoplasty was performed at the vertebral bodies which were truly responsible for the back pain.

MR-detected bone edema is not a prerequisite for the long-term benefit of kyphoplasty in patients with painful osteoporotic fractures.

Noeldge, G, Grafe, I, Da Fonseca, K, Libicher, M, Meeder, P, Kasperk, C, Kauffmann, G, et al, , MR-detected Bone Edema is Not a Prerequisite for Long-term Benefit by Kyphoplasty.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430150.html