The value of dynamic radiographs in diagnosing painful vertebrae in osteoporotic compression fractures

Many authors have reported the increase in vertebral body height after vertebroplasty; if the fractured vertebrae are mobile, we should be able to demonstrate their mobility in radiographs. The purpose of this study was to discover the diagnostic value of dynamic radiographs and the percentage of mobile vertebrae in painful VCFs.

From September 2005 to September 2008, 105 patients underwent surgery to treat 144 painful osteoporotic VCFs. The indications for surgery were severe pain and MR imaging-confirmed active edematous lesions. Preoperative sitting lateral radiographs of the fractured vertebrae were compared with supine cross-table (with a bolster beneath) lateral radiographs to determine the presence or absence of dynamic mobility. Kyphotic angle and anterior vertebral body height were measured.

The patients' ages ranged from 62 to 90 years. There were 19 men and 86 women. The total number of mobile VCFs was 126 (87.5%). One hundred four (99%) patients had at least 1 mobile VCF. The average anterior vertebral height in sitting lateral radiographs was 13.53 ± 6.80 mm and increased to 22.01 ± 6.13 mm in supine cross-table with bolster lateral radiographs. The average vertebral body height increase was 8.48 ± 5.36 mm.

Dynamic (sitting and supine with bolster) radiographs can be valuable in diagnosing painful vertebrae in VCFs. The sensitivity was 0.88 in this study.