Additional Magnetic Resonance or Nuclear Scintigraphy Imaging Influences Approach to Vertebral Augmentation: A Single Institution Experience.

STUDY DESIGN: Retrospective review OBJECTIVE.: To ascertain impact of pre-procedural MRI or nuclear medicine Tc99m-DMP scintigraphy on the treatment plan when compared with plain films and/or CT prior to vertebral augmentation procedures. SUMMARY OF BACKGROUND DATA: Over one million vertebral compression fractures (VCFs) occur in the U.S. annually with over 150,000 individuals hospitalized each year. Physical exam and history are essential to the workup of VCFs, but imaging remains necessary for confirming the diagnosis. VCFs can be imaged with various modalities and there is limited data on the comparative effectiveness of different imaging modalities. METHODS: 650 consecutive patients treated with vertebral augmentation at a single institution between May of 2013 and April of 2018 were reviewed. Pre-procedure imaging of the spine obtained within 30 days prior to the procedure were reviewed. Pre-procedure imaging results were cross-referenced against the levels treated by vertebral augmentation to determine whether there was a change in the levels treated after receiving an MRI or NM imaging study. RESULTS: 363 patients had adequate imaging for inclusion. 154 of these 363 patients (42.4%) had an alteration of their treatment plan based upon the MR or NM imaging. Fewer vertebral levels were treated in 33, different levels were treated in 41, and more levels were treated in 80 patients. CONCLUSION: MRI or nuclear medicine bone scan imaging prior to vertebral augmentation altered the location and number of levels treated in a large percentage of patients, adding specificity to treatment over findings on radiographs or CT alone. LEVEL OF EVIDENCE: 3.

Duke Scholars

Author Jonathan Martin Radiology, Interventional Radiology