Clinical diagnosis of vertebral compression fracture caused by osteoporosis, spinal metastases and multiple myeloma
YANG Yang
HUANG Wei-min
SONG Ruo-xian
YU Xiu-chun
Abstract：Objective To observe the clinical symptoms, laboratory results, images of vertebral compression fractures to analyze the diagnosis procedures to reduce the misdiagnosis rate. Methods All 368 cases of vertebral compression fractures were reviewed from 2008. 2 to 2017. 7. There were 116 males, 262 females. All patients were divided into 3 groups: Group A ( osteoporosis, n = 215 ); Group B ( metastases, n = 119 ); Group C ( multiple myeloma, n=44).Observation index:sex,age,BMI,nerve signs,VAS.Laboratory examination:Hemoglobin,ESR,A/G,tumor markers. Imaging features: morphological characteristics, vertebral signals, pedicle and appendage, linear high signals in the vertebral body, soft tissue mass, vertebral edge. An independent sample t test or Mann-Whitney U test was used to compare the results among 3 groups. Chi square test was used to compare the counting data. Results Group A: the average age was older ( tAB= -3.581, P = 0.023; tAC= -3.979, P = 0.011 ); more women ( χ2AB= 38.369, P = 0.000; χ2AC=69.295, P = 0.000 ); lower BMI ( ZAB= -4.011, P = 0.015; ZAC= -7.454, P = 0.000 ); lower VAS score ( ZAB= -2.375, P=0.045;ZAC=-2.463,P=0.047).Group B:Neuropathic symptoms often occurred(χ2AB=120.297,P=0.000;χ2BC=35.108, P = 0.000 ); more positive tumor markers ( χ2AB= 122.738, P = 0.000; χ2BC= 30.032, P = 0.000 ); Group C:more positive ESR A / G and HGB rates ( χ2AC= 124.213, P = 0.000; χ2BC= 81.941, P = 0.000 ). Vertebrae wedge often occurred in Group A ( χ2AB= 87.765, P = 0.000; χ2AC= 58.607, P = 0.000 ). Vertebrae biconcave often occurred in Group A and C ( χ2AB= 12.309, P = 0.000; χ2BC= 14.677, P = 0.000 ). Vertebrae plana often occurred in Group B and C ( χ2AB= 177.179, P = 0.000; χ2AC= 80.349, P = 0.000 ). The MRI signal short T1and long T2often occurred in Group A and C ( χ2AB= 62.127, P = 0.000; χ2BC= 25.329, P = 0.000 ). Pedicle involvement often occurred in Group B ( χ2AB=173.577, P = 0.000; χ2BC= 38.564, P = 0.000 ). Soft tissue mass often occurred in Group B ( χ2AB= 317.126, P = 0.000;χ2AC=233.000,P=0.000).Linear high signal often occurred in Group A(χ2AB=317.126,P=0.000;χ2AC=233.000, P=0.000).Bulge of posterior vertebral edge often occurred in Group B(χ2AB=174.031,P=0.000;χ2BC=58.704, P=0.000).Conclusions The diagnosis of vertebral compression fractures caused by osteoporosis,spinal metastases and multiple myeloma should be made combining with clinical features, laboratory examination and radiological data. For the patients with unidentified diagnosis, ECT, PET-CT, bone marrow aspiration and lesion biopsy should be further performed to reduce the misdiagnosis rate.
Keywords：OsteoporosisMultiple myelomaDiagnosisdifferential
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 357-363 )