Cargando…
Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures
BACKGROUND: Dynamic radiographs are recommended to investigate non-healing evidence such as the dynamic mobility or intravertebral clefts in osteoporotic vertebral compression fractures (VCFs). However, it is difficult to examine standing flexion and extension lateral radiographs due to severe pain....
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Orthopaedic Association
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758989/ https://www.ncbi.nlm.nih.gov/pubmed/24009905 http://dx.doi.org/10.4055/cios.2013.5.3.195 |
_version_ | 1782477187868262400 |
---|---|
author | Cho, Jae Hwan Shin, Sang Ik Lee, Jae Hyup Yeom, Jin Sup Chang, Bong-Soon Lee, Choon-Ki |
author_facet | Cho, Jae Hwan Shin, Sang Ik Lee, Jae Hyup Yeom, Jin Sup Chang, Bong-Soon Lee, Choon-Ki |
author_sort | Cho, Jae Hwan |
collection | PubMed |
description | BACKGROUND: Dynamic radiographs are recommended to investigate non-healing evidence such as the dynamic mobility or intravertebral clefts in osteoporotic vertebral compression fractures (VCFs). However, it is difficult to examine standing flexion and extension lateral radiographs due to severe pain. The use of prone cross-table lateral radiographs (PrLRs) as a diagnostic tool has never been proposed to our knowledge. The purpose of this study is to clarify the usefulness of PrLRs in diagnosis and treatment of VCFs. METHODS: We reviewed 62 VCF patients examined with PrLRs between January 1, 2008 and June 30, 2011. To compare the degree of pain provoked between standing extension lateral radiographs (StLRs) and PrLRs, numeric rating scale (NRS) scores were assessed and compared by a paired t-test. Vertebroplasty was done for 40 patients and kyphoplasty was done for 9 patients with routine manners. To assess the degree of postural reduction, vertebral wedge angles (VWA) and vertebral height ratios (VHR) were calculated by using preoperative StLRs, PrLRs, and postoperative lateral radiographs. Two variables derived from changes in VWA and VHR between preoperative and postoperative radiographs were compared by a paired t-test. RESULTS: The average NRS scores were 6.23 ± 1.67 in StLRs and 5.18 ± 1.47 in PrLRs. The degree of pain provocation was lower in using PrLRs than StLRs (p < 0.001). The average changes of VWA between preoperative and postoperative status were 5.24° ± 6.16° with PrLRs and 3.46° ± 3.47° with StLRs. The average changes of VHR were 0.248 ± 0.178 with PrLRs and 0.148 ± 0.161 with StLRs. The comparisons by two variables showed significant differences for both parameters (p = 0.021 and p < 0.001, respectively). The postoperative radiological status was reflected more precisely when using PrLRs than StLRs. CONCLUSIONS: In comparison with StLR, the PrLR was more accurate in predicting the degree of restoration of postoperative vertebral heights and wedge angles, and provoked less pain during examination. The PrLR could be a useful diagnostic tool to detect intravertebral cleft or intravertebral dynamic instability. |
format | Online Article Text |
id | pubmed-3758989 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | The Korean Orthopaedic Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-37589892013-09-04 Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures Cho, Jae Hwan Shin, Sang Ik Lee, Jae Hyup Yeom, Jin Sup Chang, Bong-Soon Lee, Choon-Ki Clin Orthop Surg Original Article BACKGROUND: Dynamic radiographs are recommended to investigate non-healing evidence such as the dynamic mobility or intravertebral clefts in osteoporotic vertebral compression fractures (VCFs). However, it is difficult to examine standing flexion and extension lateral radiographs due to severe pain. The use of prone cross-table lateral radiographs (PrLRs) as a diagnostic tool has never been proposed to our knowledge. The purpose of this study is to clarify the usefulness of PrLRs in diagnosis and treatment of VCFs. METHODS: We reviewed 62 VCF patients examined with PrLRs between January 1, 2008 and June 30, 2011. To compare the degree of pain provoked between standing extension lateral radiographs (StLRs) and PrLRs, numeric rating scale (NRS) scores were assessed and compared by a paired t-test. Vertebroplasty was done for 40 patients and kyphoplasty was done for 9 patients with routine manners. To assess the degree of postural reduction, vertebral wedge angles (VWA) and vertebral height ratios (VHR) were calculated by using preoperative StLRs, PrLRs, and postoperative lateral radiographs. Two variables derived from changes in VWA and VHR between preoperative and postoperative radiographs were compared by a paired t-test. RESULTS: The average NRS scores were 6.23 ± 1.67 in StLRs and 5.18 ± 1.47 in PrLRs. The degree of pain provocation was lower in using PrLRs than StLRs (p < 0.001). The average changes of VWA between preoperative and postoperative status were 5.24° ± 6.16° with PrLRs and 3.46° ± 3.47° with StLRs. The average changes of VHR were 0.248 ± 0.178 with PrLRs and 0.148 ± 0.161 with StLRs. The comparisons by two variables showed significant differences for both parameters (p = 0.021 and p < 0.001, respectively). The postoperative radiological status was reflected more precisely when using PrLRs than StLRs. CONCLUSIONS: In comparison with StLR, the PrLR was more accurate in predicting the degree of restoration of postoperative vertebral heights and wedge angles, and provoked less pain during examination. The PrLR could be a useful diagnostic tool to detect intravertebral cleft or intravertebral dynamic instability. The Korean Orthopaedic Association 2013-09 2013-08-20 /pmc/articles/PMC3758989/ /pubmed/24009905 http://dx.doi.org/10.4055/cios.2013.5.3.195 Text en Copyright © 2013 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Cho, Jae Hwan Shin, Sang Ik Lee, Jae Hyup Yeom, Jin Sup Chang, Bong-Soon Lee, Choon-Ki Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures |
title | Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures |
title_full | Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures |
title_fullStr | Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures |
title_full_unstemmed | Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures |
title_short | Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures |
title_sort | usefulness of prone cross-table lateral radiographs in vertebral compression fractures |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758989/ https://www.ncbi.nlm.nih.gov/pubmed/24009905 http://dx.doi.org/10.4055/cios.2013.5.3.195 |
work_keys_str_mv | AT chojaehwan usefulnessofpronecrosstablelateralradiographsinvertebralcompressionfractures AT shinsangik usefulnessofpronecrosstablelateralradiographsinvertebralcompressionfractures AT leejaehyup usefulnessofpronecrosstablelateralradiographsinvertebralcompressionfractures AT yeomjinsup usefulnessofpronecrosstablelateralradiographsinvertebralcompressionfractures AT changbongsoon usefulnessofpronecrosstablelateralradiographsinvertebralcompressionfractures AT leechoonki usefulnessofpronecrosstablelateralradiographsinvertebralcompressionfractures |