Abstract
Plain radiography in a sitting-supine position is useful for diagnosing acute osteoporotic vertebral fractures. However, its use for diagnosing pathological fractures due to metastatic spinal tumors has not been reported. Here we investigated morphologic changes in metastatic vertebral fractures using plain radiography with the patients in a sitting-supine position.
We performed radiographic analysis of 62 patients with metastatic spinal tumors, who were diagnosed by computed tomography, magnetic resonance imaging, and/or positron emission tomography. We obtained anteroposterior and lateral radiographs, and then compared sitting and supine radiographs to evaluate the presence of an unstable metastatic vertebral body.
There were 65 pathological fractures in 41 patients, and 27 unstable metastatic vertebral bodies in 24 patients. Instability was recognizable in 7 vertebral bodies only in anteroposterior radiographs. Twenty-two patients (91.7%) had pain on movement of the spine due to unstable collapsed vertebral bodies, of whom 8 (47.1%) had stable collapse, and 7 (33.3%) non-collapse.
Evaluation of metastatic vertebral body instability using this approach probably helps to determine the plan of treatment for metastatic spinal tumors.
