Magnetic-resonance tomography in valuation of vertebral-medullary conflict in metastatic compression spread fractures

Abstract

Magnetic-resonance tomography in valuation of vertebral-medullary conflict in metastatic compression spread fractures Objective: to determine the vertebral-medullary conflict and its degree in patients with metastatic compression fractures and metastatic spine using MRI. Material and methods: The total examination of 50 patients with metastatic compression fractures of the spine was conducted. All patients underwent magnetic resonance imaging on devices with magnetic fields 0.2T, 0.36T and 1.5T. To assess the degree of involvement of the lumen spinal canal studied the degree of vertebral-medullary conflict: Grade I – compression of adipose tissue to the dural sac; Grade II– a slight deformation of the dural sac (25%); Grade III – compression of the dural sac up to ¼ the size of the dural sac (50%); IV Grade – compression of more than ¼ of the dural sac (over 50%). Results: Vertebral-medullary conflict Grade I at acute osteoporotic compression fractures was revealed in 10% of patients, II – in 28%, III - in 24% and IV – in 36% of patients. III and IV degrees of vertebral-medullary conflict constituted 60%, which was accompanied by a corresponding deficit of neurologic symptoms before the development of the paraparesis. Conclusions: 1. With metastatic compression fractures, the degree of vertebral-medullar conflict progressively increases, up to the complete compression of the vertebral channel (36%), compared with those in osteoporosis (7.4%). 2. In pathological compression fractures of the spine, severe degrees of vertebral-medullar conflict are six times more often in metastatic fractures.