Can Bone Scintigraphy Play a Role in Identification and Assessment of Vertebral Compression Fractures?

Abstract Purpose: This study aims to evaluate the role of bone scintigraphy (BS) in identifying and assessing the age of vertebral compression fractures (VCFs). Methods: A total of 190 patients with VCFs, eligible for vertebral augmentation surgery, underwent computed tomography (CT) and BS. The CT and scintigraphic patterns of 2966 vertebrae were compared. Results: The CT and BS findings were concordant in the majority of cases (95.5%), including 84.4% normal vertebrae, 6.4% acute VCFs, and 4.7% chronic VCFs. However, in 37 patients, 45 occult acute VCFs were only detected on BS and not on CT. Multivariate logistic regression analysis revealed that these patients were older and had lower bone density compared to the rest of the study population. Additionally, 40 patients had acute VCFs visible on CT but with no increased or low intensity uptake on BS. These cases were associated with a shorter time period between trauma and BS, a higher prevalence of male patients, and higher bone density. Acute VCFs with no increased uptake or low levels of uptake were found within six days of the trauma. Conclusion: BS provides valuable information about the age of VCFs, detects radiologically occult fractures, and can serve as a cost-effective alternative to MRI. To avoid missing acute VCFs, BS should be performed six days or more after the injury.