MRI and bone scan imaging in the preoperative evaluation of painful vertebral fractures treated with vertebroplasty and kyphoplasty.

BACKGROUND This study compared the role and timing of bone scintigraphy and magnetic resonance imaging (MRI) in the evaluation of vertebral compression fractures (VCFs), before treatment with vertebroplasty and kyphoplasty. To our knowledge, no prior articles have described, in osteoporotic and pathological vertebral fractures, the role of MRI and bone scintigraphy as pre-procedural work up in those patients candidated to undergo spinal interventional procedures. MATERIALS AND METHODS A retrospective chart review was performed of thirty patients treated with interventional procedures for painful vertebral fractures at our institution between January 2002 and July 2003. RESULTS In patients, selected after evaluation with MRI and bone scan imaging, both procedures demonstrated swift pain relief associated with vertebral resistance augmentation. CONCLUSION MRI revealed itself to be equivalent to bone scan imaging in selecting patients to be treated with vertebroplasty and kyphoplasty in the first 3/4 months, while bone scintigraphy was more accurate in the evaluation of elderly fractures (> 3/4 months). MRI was superior to bone scintigraphy in vertebral collapses due to multiple myeloma.