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MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

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Abstract

Introduction

Magnetic resonance images (MRI) fluid sign and intravertebral vacuum phenomenon of the plain radiograph are considered as the characteristic radiological findings for vertebral osteonecrosis after spinal fractures. We aim to study the association between the radiological and histopathologic findings of vertebral osteonecrosis through the use of an open retrieval of specimens.

Materials and methods

Twenty consecutive patients (54–84 years, mean 73 years) of unstable vertebral compression fractures treated with anterior corpectomy and fusion were included. All the images and pathologies were correlated, especially the histopathologic changes to the fluid sign and vacuum phenomenon.

Results

MRI fluid signs and the histopathologic findings of vertebral osteonecrosis were significantly correlated and both were noted in the first 5 months after injury. The power of the fluid sign in diagnosing vertebral osteonecrosis was better than that of the intravertebral vacuum phenomenon (diagnostic odds ratio 65 vs. 2, sensitivity 86 vs. 50 %, specificity 100 vs. 67 %).

Conclusion

MRI fluid sign is more predictable to diagnose vertebral osteonecrosis in operative case, especially within the initial 5 months after injury.

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Authors and Affiliations

  1. Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan

    Cheng-Li Lin

  2. Department of Orthopaedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng-Li Road, Tainan City, 70428, Taiwan

    Cheng-Li Lin, Ruey-Mo Lin & Kuo-Yuan Huang

  3. Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan

    Cheng-Li Lin

  4. Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan

    Jing-Jou Yan & Yu-Shan Yan

  5. Division of Orthopaedics, Department of Surgery, National Cheng Kung University Hospital DouLiou Branch, National Cheng Kung University, Yunlin, Taiwan

    Cheng-Li Lin & Ruey-Mo Lin

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Correspondence to Ruey-Mo Lin.

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Lin, CL., Lin, RM., Huang, KY. et al. MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study. Eur Spine J 22, 1617–1623 (2013). https://doi.org/10.1007/s00586-012-2618-z

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  • DOI: https://doi.org/10.1007/s00586-012-2618-z

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