Cambridge Pain Management, Wembly, WA, Australia.
J Pain Res. 2013 May 10;6:359-65. doi: 10.2147/JPR.S32151. Print 2013.
To determine whether X-ray, computed tomography (CT), bone scan, and clinical impression accurately reflect the level of vertebral fracture in patients about to undergo vertebroplasty.
Retrospective observational study, utilizing patient inpatient notes, referral correspondence, and clinicians' private notes.
Single center - all patients referred to one pain medicine physician for vertebroplasty who subsequently had the procedure.
All patients referred to a pain physician (PJG) over a 4-year period, who had a presumptive diagnosis of vertebral fracture(s) from the referring consultant physician, based on imaging other than magnetic resonance imaging (MRI) and clinical impression. Participants then had an MRI and subsequent vertebroplasty under the care of the pain physician. Participants were identified retrospectively from the vertebroplasty procedure list.
Nil.
Number of cases in which the MRI identified a different level of pathology than X-ray, CT, bone scan, and clinical impression.
In 50% (28/56) of patients MRI identified a fracture at a different level to that which was presumed to be the cause of patient pain on the basis of X-ray, CT, and clinical impression.
MRI is an essential investigation to determine accurately the level of fracture in osteoporotic patients. Studies on the effectiveness of treatment of vertebral fractures that do not utilize MRI in every case are unlikely to be accurate.
确定 X 射线、计算机断层扫描 (CT)、骨扫描和临床印象是否准确反映即将接受椎体成形术治疗的患者的椎体骨折程度。
回顾性观察研究，利用患者住院病历、转诊信函和临床医生的私人笔记。
单中心 - 所有被转诊至一位疼痛科医生接受椎体成形术的患者，这些患者随后都接受了该手术。
所有被转诊给疼痛科医生（PJG）的患者在 4 年内，根据 MRI 以外的影像学检查和临床印象，由转诊顾问医生初步诊断为椎体骨折。随后，参与者接受 MRI 检查，并在疼痛科医生的治疗下接受后续的椎体成形术。参与者是从椎体成形术程序列表中回顾性确定的。
无。
MRI 识别出与 X 射线、CT、骨扫描和临床印象不同的病变水平的病例数。
在 50%（28/56）的患者中，MRI 确定的骨折部位与 X 射线、CT 和临床印象推测的导致患者疼痛的骨折部位不同。
MRI 是准确确定骨质疏松性患者骨折程度的必要检查。如果在每个病例中都不使用 MRI 的研究来评估椎体骨折的治疗效果，那么这些研究很可能是不准确的。
