Association between MRI findings and back pain after osteoporotic vertebral fractures: a multicenter prospective cohort study.
BACKGROUND CONTEXT
Osteoprotic vertebral fractures (OVFs) are common in elderly people. The association between back pain due to OVF with magnetic resonance imaging (MRI) signal change is unclear. In this study we hypothesized that MRI findings would be a predictive factor for back pain measured by visual analogue scale (VAS) at 6 months follow-up.


PURPOSE
The aim was to study the MRI findings that predict back pain after OVF and the association between radiological findings and scores of back pain.


STUDY DESIGN
Multicenter prospective cohort study.


PATIENT SAMPLE
A total of 153 OVF patients.


OUTCOME MEASURE
The outcome measures were VAS back pain and MRI signal change.


METHODS
This study was performed from 2012 to 2015. Consecutive patients with less than 2-week-old OVFs at 11 institutions were enrolled prospectively. MRI was performed at enrollment and at 1, 3, and 6 months follow-up. T1- and T2-weighted images (T1WI and T2W1) were obtained at each time point and their association with VAS scores of back pain at 6 months were investigated. Anterior compression ratio, posterior compression ratio, and angular motion of vertebral bodies were also measured on X-rays at each follow-up. This research had no financial support. There are no conflicts of interest.


RESULT
The 6 months follow-up was completed by 153 patients. At enrollment, the average VAS score of back pain was 75 mm, and it had improved at the 6-month follow-up to an average score of 20 mm. There was a significant correlation between T1 diffuse low signal change and VAS scores at the 6-month follow-up (p<.01). T2 high signal changes (odds ratio; 4.01, p<.01) and old vertebral fractures (odds ratio; 2.47, p=.04) were independent risk factors for back pain. The correlation between angular motion of vertebrae on X-rays and the VAS score of back pain was significant at all time points.


CONCLUSION
This study demonstrates the radiological factors associated with persistent back pain after an OVF and the association between the VAS score of back pain and radiological findings. In addition, T2 high signal changes in acute phase and old vertebral fractures were independent risk factors for residual back pain.
['Ahmadi|Sayed Abdullah|SA|', 'Takahashi|Shinji|S|', 'Hoshino|Masatoshi|M|', 'Takayama|Kazushi|K|', 'Sasaoka|Ryuichi|R|', 'Tsujio|Tadao|T|', 'Yasuda|Hiroyuki|H|', 'Kanematsu|Fumiaki|F|', 'Kono|Hiroshi|H|', 'Toyoda|Hiromitsu|H|', 'Nakamura|Hiroaki|H|']
D000368:Aged D000369:Aged, 80 and over D001416:Back Pain D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D058866:Osteoporotic Fractures D016103:Spinal Fractures
Association between MRI Back pain Vertebral fracture Magnetic resonance imaging MRI signal changes Osteoporosis Risk factors for persistent back pain X-ray and VAS score of back pain