Asymmetrical vertebral collapse from spinal metastasis in lower thoracic and lumbar spine.
J Orthop Sci
; 22(3): 405-410, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28081926
ABSTRACT
OBJECTIVE:
The purpose of this study was to investigate the differences between spinal metastasis and osteoporotic compression fractures on plain X-ray images, focusing on asymmetrical vertebral collapse and fracture level. MATERIALS ANDMETHODS:
This study included 180 patients with pathological collapse from spinal metastasis (188 vertebrae) who were treated at our institution and 70 patients (92 vertebrae) with osteoporotic compression fractures. Anteroposterior X-ray images of the lower thoracic and lumbar spine were evaluated for asymmetrical collapse deformity.RESULTS:
Asymmetrical collapse was found in 134 vertebrae (71.3%) with metastasis, and in 20 osteoporotic vertebrae (21.7%); this difference was significant (p < 0.0001). The asymmetrical collapse angle in spinal metastasis patients ranged from 0 to 18°, with a mean of 7.0 and a standard deviation (SD) of 4.5. In contrast, the asymmetrical collapse angle in patients with osteoporotic fractures ranged from 0 to 13°, with a mean of 3.1 and a SD of 2.8. The difference in collapse angle between the two groups was statistically significant (p < 0.001). The cutoff value to suspect spinal metastasis was determined to be 5° or more (sensitivity 0.67, specificity 0.74). Fracture at Th10 or below L3 was found in 20.2% of spinal metastasis patients; only 3% of osteoporotic fractures occurred at these levels.CONCLUSION:
Asymmetrical collapse with an angle of 5° or more and fractures at atypical levels on plain radiographs can be useful clues to spinal metastasis.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Coluna Vertebral
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Vértebras Torácicas
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Fraturas da Coluna Vertebral
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Fraturas por Compressão
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Vertebroplastia
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Fraturas Espontâneas
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Vértebras Lombares
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article