Impact of Magnetic Resonance Imaging on Treatment-Related Decision Making for Osteoporotic Vertebral Compression Fracture: A Prospective Randomized Trial

BACKGROUND The aim of this study was to analyze the impact and usefulness of characteristic signal change of a linear black signal on magnetic resonance imaging (MRI) on treatment-related decision making. MATERIAL AND METHODS Forty-one patients with a linear black signal on MRI were enrolled in this prospective study. They were randomly divided into the percutaneous kyphoplasty (PKP) group (n=24) and the conservative treatment group (n=17). Clinical measures, including visual analog scale (VAS) and short-form 36 (SF-36) questionnaire, were analyzed. Radiographic measures, including anterior vertebral body height, kyphosis angle and rate of bone-union, were evaluated. RESULTS VAS scores were significantly lower in the PKP group than in the conservative treatment group post-treatment and at one-year follow-up. After one year of treatment, the values for physical functioning, physical health, and body pain were significantly higher in the PKP group than in the conservative treatment group (p<0.05). The PKP group had a significantly higher anterior vertebral body height, rate of bone-union, and lower kyphosis angle than the conservative treatment group at one-year follow-up (p<0.05). CONCLUSIONS In patients with a linear black signal detected on MRI, the first-choice treatment should be PKP rather than conservative treatment.