Accuracy of magnetic resonance imaging in differentiating benign and malignant causes of vertebral collapse

Vertebral collapse is the breakdown of a vertebra resulting in a decreased height of its body. The collapse may occur to a variable extent. Vertebral collapse is associated with an increased width of the body with possible bulging of the posterior wall towards the spinal canal and consequent spinal cord or nerve root compression in severe cases. While the diagnosis of vertebral collapse is easily accomplished with plain X-ray films, etiology & in particular differentiation between benign osteoporotic vertebral collapses from tumoral replacement is difficult. Objectives: Evaluate the accuracy of various magnetic resonance imaging (MRI) features in differentiating malignant from benign vertebral collapses. Analyse the sensitivity & specificity of MR imaging in differentiating causes of vertebral collapse. Methods: The study is basically a prospective observational study conducted from December 2014 to June 2016. The group comprised of patients who attended Department of Radiodiagnosis & orthopaedics with complaint of back pain, lower limb weakness & generalized body ache. A detailed clinical history was obtained from all patients. Detailed examination and findings were recorded. Results: Accuracy of pedicle involvement (96%), convex posterior border(90%),homogenenous replaced marrow (74%) and paravertebral spinal mass (86%) was found to be high in cases of malignant vertebral collapse, which helps in accurately differentiating it from benign vertebral collapse. Conclusion: MRI is well known useful method in evaluating diseases of bone and bone marrow and one of the reliable method to differentiate between benign and malignant etiology Thus, it was concluded in our study that the MRI helps 1.differentiating between benign and malignant etiology 2.deciding in surgical and nonsurgical treatment options which are available to achieve the goals of preservation of neurologic function and restoration of spinal stability.