Endplate and intervertebral disc injuries in acute and single level osteoporotic vertebral fractures: is there any association with the process of bone healing?
Endplate injury
Intervertebral disc injury
Osteoporosis
Vertebral fracture
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
19 Jul 2019
19 Jul 2019
Historique:
received:
29
10
2018
accepted:
15
07
2019
entrez:
21
7
2019
pubmed:
22
7
2019
medline:
14
1
2020
Statut:
epublish
Résumé
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. Endplate and IVD injuries are usually found in association with vertebral fractures (VFs); however, little is known about their relevance to the healing of osteoporotic VFs (OVFs). The first purpose of this study was to evaluate the incidence and occurrence pattern of endplate and IVD injuries associated with single- and acute-OVFs, and the second was to evaluate the influence of endplate and IVD injuries on the occurrence of delayed union. Endplate and IVD injuries associated with single- and acute-OVFs were retrospectively evaluated using magnetic resonance imaging (MRI). Vertebrae of 168 patients were included in the study. The occurrence rate and type of endplate and IVD injuries were radiologically evaluated, and the association between endplate and IVD injuries was statistically analyzed. Vertebrae of 85 patients, who received conservative treatment for acute OVFs, were included in the study and classified into two groups, union and delayed union, at 6 months after injury. To identify factors predicting delayed union, uni- and multivariate statistical analyses were performed. Vertebral MRI signal alternation patterns and endplate and IVD injuries were included as candidate factors in the logistic model. In association with OVFs, endplate injuries were observed in 103 of the 168 vertebrae (61%), and IVDs lesions were observed in 101 of 168 OVFs (60%); the occurrence of both injuries was significantly associated. Although no significant association with endplate and IVD injuries was identified, multivariate analysis demonstrated that intravertebral signal alternation (focal high signal intensity) and posterior wall injury were independent risk factors that predicted delayed union. The results of this study showed that endplate and IVD injuries were found in approximately 60% of single and acute OVFs. These results suggest that fracture healing of OVFs would be mainly attributed to vertebral factors, including mechanical stress and metabolic status, among the three components of the anterior spinal column.
Sections du résumé
BACKGROUND
BACKGROUND
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. Endplate and IVD injuries are usually found in association with vertebral fractures (VFs); however, little is known about their relevance to the healing of osteoporotic VFs (OVFs). The first purpose of this study was to evaluate the incidence and occurrence pattern of endplate and IVD injuries associated with single- and acute-OVFs, and the second was to evaluate the influence of endplate and IVD injuries on the occurrence of delayed union.
METHODS
METHODS
Endplate and IVD injuries associated with single- and acute-OVFs were retrospectively evaluated using magnetic resonance imaging (MRI). Vertebrae of 168 patients were included in the study. The occurrence rate and type of endplate and IVD injuries were radiologically evaluated, and the association between endplate and IVD injuries was statistically analyzed. Vertebrae of 85 patients, who received conservative treatment for acute OVFs, were included in the study and classified into two groups, union and delayed union, at 6 months after injury. To identify factors predicting delayed union, uni- and multivariate statistical analyses were performed. Vertebral MRI signal alternation patterns and endplate and IVD injuries were included as candidate factors in the logistic model.
RESULTS
RESULTS
In association with OVFs, endplate injuries were observed in 103 of the 168 vertebrae (61%), and IVDs lesions were observed in 101 of 168 OVFs (60%); the occurrence of both injuries was significantly associated. Although no significant association with endplate and IVD injuries was identified, multivariate analysis demonstrated that intravertebral signal alternation (focal high signal intensity) and posterior wall injury were independent risk factors that predicted delayed union.
CONCLUSIONS
CONCLUSIONS
The results of this study showed that endplate and IVD injuries were found in approximately 60% of single and acute OVFs. These results suggest that fracture healing of OVFs would be mainly attributed to vertebral factors, including mechanical stress and metabolic status, among the three components of the anterior spinal column.
Identifiants
pubmed: 31324243
doi: 10.1186/s12891-019-2719-5
pii: 10.1186/s12891-019-2719-5
pmc: PMC6642561
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
336Références
Spine (Phila Pa 1976). 2001 Apr 15;26(8):889-96
pubmed: 11317111
Eur Spine J. 2003 Oct;12 Suppl 2:S97-S103
pubmed: 13680317
Spine (Phila Pa 1976). 2004 Dec 1;29(23):2700-9
pubmed: 15564919
Neurosurg Focus. 2001 Apr 15;10(4):E1
pubmed: 16732625
Eur Radiol. 2006 Nov;16(11):2533-41
pubmed: 16775692
Eur Spine J. 2008 Nov;17(11):1522-30
pubmed: 18795344
J Mech Behav Biomed Mater. 2010 Jan;3(1):31-40
pubmed: 19878900
Eur Spine J. 1993 Mar;1(4):214-21
pubmed: 20054920
AJNR Am J Neuroradiol. 2011 Jan;32(1):115-20
pubmed: 20801764
J Biomech. 2010 Dec 1;43(16):3126-31
pubmed: 20817162
Spine (Phila Pa 1976). 2011 Jul 1;36(15):1229-35
pubmed: 21217433
Arch Orthop Trauma Surg. 2011 Dec;131(12):1703-10
pubmed: 21805360
Br Med Bull. 2012 Jun;102:171-89
pubmed: 22130906
Spine (Phila Pa 1976). 2012 Jun 1;37(13):1115-21
pubmed: 22158062
J Neurosurg Spine. 2012 Nov;17(5):469-75
pubmed: 22938553
Spine (Phila Pa 1976). 2013 May 15;38(11):E641-8
pubmed: 23429686
AJR Am J Roentgenol. 2013 Mar;200(3):618-23
pubmed: 23436852
Eur Spine J. 2013 Jul;22(7):1633-42
pubmed: 23549907
Clin Radiol. 2013 Nov;68(11):e617-23
pubmed: 23932678
J Spinal Disord Tech. 2014 Apr;27(2):E61-5
pubmed: 24201154
Osteoporos Int. 2016 Dec;27(12):3567-3575
pubmed: 27344644
BMC Musculoskelet Disord. 2017 Apr 7;18(1):148
pubmed: 28388910
BMC Musculoskelet Disord. 2017 Jun 5;18(1):244
pubmed: 28583099
J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017717194
pubmed: 28681673
Eur Spine J. 2018 Oct;27(10):2565-2576
pubmed: 29030703
J Orthop Sci. 2018 Jul;23(4):627-634
pubmed: 29680168
BMC Musculoskelet Disord. 2018 May 24;19(1):164
pubmed: 29793459
BMC Musculoskelet Disord. 2018 Nov 20;19(1):406
pubmed: 30458738
Spine (Phila Pa 1976). 1986 Sep;11(7):726-31
pubmed: 3787344
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
Spine (Phila Pa 1976). 1998 Oct 15;23(20):2201-6
pubmed: 9802162