2021 Volume 12 Issue 6 Pages 875-881
INTRODUCTION: The endplate-intervertebral disc (IVD) complex is closely interrelated with the vertebral body (VB) in the structural integrity of the anterior spinal column, including biomechanical and biological functions. Our previous study showed that endplate and intervertebral disc injuries occurred frequently with osteoporotic vertebral fractures (OVFs), and these injuries were not significant independent risk factors of delayed union at six months after injury. However, the impact of these injuries on the other important outcome of OVF treatment, vertebral collapse assessment, was not determined. The purpose of this study was to elucidate the association of endplate and/or IVD injuries with the progression of vertebral collapse by semi-quantitative assessment.
METHODS: Endplate and IVD injuries associated with single- and acute-OVFs were retrospectively evaluated using magnetic resonance imaging (MRI). The vertebrae of 72 patients (male: 13, female: 59, mean age: 79.5 years) who received conservative treatment for at least 6 months were included in this study. Using the lateral view of the plain radiograph in the sitting position, anterior (A), center (C), and posterior (P) vertebral collapse was evaluated by a semi-quantitative technique at baseline and six months after injury. The progression of vertebral collapse was classified by semi-quantitative grade at 6 months compared to baseline and classified into two groups (advanced collapse group/no advanced collapse group) To identify factors that impact vertebral collapse, statistical analyses were performed.
RESULTS: Overall, 13 of 72 patients were in the advanced collapse group. Progression of vertebral collapse occurred more frequently in the case of OVFs with IVD injuries (10 of 51 patients: 20%) or EP injuries (8 of 42 patients: 19%) compared with cases without IVD/EP injury (1 of 14 patients: 7%). However, these factors were not significantly associated with the progression of vertebral collapse. The other patient characteristics at baseline (age, sex, level of fracture) were also not significantly associated with the progression of vertebral collapse in this study.
DISCUSSION: The endplate and IVD injuries in OVFs were not significantly associated with the progression of vertebral collapse using semi-quantitative assessment. To evaluate the impact of endplate and/or IVD injuries on OVF treatment outcomes comprehensively, a pain scale and health-related quality of life should also be examined in a future study.
