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Relationship between clinical symptoms of osteoporotic vertebral fracture with intravertebral cleft and radiographic findings

Artikel i vetenskaplig tidskrift
Författare T. Nakamae
Y. Fujimoto
K. Yamada
T. Hiramatsu
T. Hashimoto
Kjell Olmarker
N. Adachi
Publicerad i Journal of Orthopaedic Science
Volym 22
Nummer/häfte 2
Sidor 201-206
ISSN 0949-2658
Publiceringsår 2017
Publicerad vid Institutionen för biomedicin, avdelningen för medicinsk kemi och cellbiologi
Sidor 201-206
Språk en
Länkar doi.org/10.1016/j.jos.2016.12.002
Ämnesord percutaneous vertebroplasty, fusion surgery, spinal-fusion, pain, decompression, epidemiology, deficit, body, Orthopedics
Ämneskategorier Kirurgi, Epidemiologi, Ortopedi

Sammanfattning

Background: With aging of the population, the numbers of osteoporotic vertebral fractures with intravertebral cleft have been increasing. However, the details of clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft are poorly understood. The purpose of this study was to evaluate the relationship between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings. Methods: Two hundred seventeen patients with single-level osteoporotic vertebral fractures with intravertebral cleft were examined. Clinical symptoms were evaluated using Numerical Rating Scale for back pain and the Oswestry Disability Index for physical disability. The presence of delayed neurologic deficit was also detected. Radiography and computed tomography were used to measure local kyphotic angle and vertebral instability and to detect the presence of posterior wall fracture of the vertebral body. Correlations between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings were investigated. Results: Mean Numerical Rating Scale and Oswestry Disability Index were 7.4 and 58.0%, respectively. Delayed neurologic deficit occurred in 41 patients (19%). The mean local kyphotic angle, vertebral instability, and rate of posterior wall fracture of the vertebral body were 19.4 degrees, 7.3 degrees, and 91%, respectively. Numerical Rating Scale and Oswestry Disability Index were statistically correlated with vertebral instability but not with local kyphotic angle and presence of posterior wall fracture. In the patients with delayed neurologic deficit, vertebral instability was significantly higher and posterior wall fractures were significantly more frequent than in the patients without delayed neurologic deficit. Local kyphotic angle was not correlated with delayed neurologic deficit. Conclusions: Vertebral instability is a factor causing symptoms of osteoporotic vertebral fractures with intravertebral cleft. In addition, vertebral instability may be the predominant cause of delayed neurologic deficit. To manage osteoporotic vertebral fractures with intravertebral cleft and delayed neurologic deficit efficiently, it may be important to control vertebral instability of osteoporotic vertebral fractures. (C) 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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http://www.gu.se/forskning/publikation/?publicationId=253334
Utskriftsdatum: 2019-12-06