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AJNR - American Journal of Neuroradiology

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Bone Marrow Edema in Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebroplasty and Relation with Clinical Outcome

M.H.J. Voormolen^a, W.J. van Rooij^a, Y. van der Graaf^c, P.N.M. Lohle^a, L.E.H. Lampmann^a, J.R. Juttmann^b and M. Sluzewski^a

^a Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands
^b Department of Internal Medicine, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands
^c Department of Clinical Epidemiology, Julius Centre for Health Sciences and Primary Care, Utrecht, the Netherlands

View larger version (24K): [in a new window]   Fig 1. Extent of bone marrow edema (BME) in 89 treated vertebral compression fractures before the procedure (0 month) and at follow-up intervals after percutaneous vertebroplasty (PV) in 64 patients.

View larger version (122K): [in a new window]   Fig 2. Sagittal short inversion recovery (STIR) (A) and T1-weighted image (B) follow-up in a patient with osteoporotic vertebral compression fracture (VCF) T12 treated by percutaneous vertebroplasty (PV). Visual analog score for pain before (0) and at 3, 6, and 12 months after PV: 10, 2, 1, and 1, respectively. Patient used morphine pre-procedure (0) and no pain medication at 3, 6, and 12 months after PV. Percentage bone marrow edema (based on all images) in VCF T12 before (0) and at 3, 6, and 12 months after PV: 75%, 25%, 20%, and 0%, respectively.

View larger version (137K): [in a new window]   Fig 3. Small hyperintense rim on sagittal short inversion recovery (STIR) and hypointense on T1-weighted image, comparable with the signal intensity of water, directly surrounding the cement cast at 6-month follow-up after PV of VCF L1.

View larger version (13K): [in a new window]   Fig 4. Median visual analog scale (VAS) score for pain in 31 patients (subgroup A) before percutaneous vertebroplasty (PV) and at follow-up intervals.

View larger version (18K): [in a new window]   Fig 5. Use of analgesics in 31 patients (subgroup A) before percutaneous vertebroplasty (PV) and at follow-up intervals.