Prevalence of benign osseous lesions of the spine and association with spinal pain in the general population in whole body MRI


Autoři: Richard Kasch aff001;  Josephin Scheele aff001;  Mark Hancock aff002;  André Hofer aff001;  Christopher Maher aff003;  Robin Bülow aff004;  Jörn Lange aff005;  Andreas Lahm aff001;  Matthias Napp aff005;  Georgi Wassilew aff001;  Carsten Oliver Schmidt aff007
Působiště autorů: Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany aff001;  Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Sydney, Australia aff002;  The University of Sydney, Sydney School of Public Health, NSW, Sydney, Australia aff003;  Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany aff004;  Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine; Department of Trauma Surgery, University Medicine Greifswald, Greifswald, Germany aff005;  Kliniken Maria Hilf Mönchengladbach, Academic Teaching Hospital of the RWTH Aachen, Mönchengladbach, Germany aff006;  Institute for Community Medicine, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany aff007
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0219846

Souhrn

Background

Benign osseous lesions of the spine are common but precise population prevalence estimates are lacking. Our study aimed to provide the first population-based prevalence estimates and examine association with back and neck pain.

Materials and methods

We used data from the population-based Study of Health in Pomerania (SHIP). Whole-body MRI examinations (1.5 Tesla: T1, T2, and TIRM weightings) were available from 3,259 participants. Readings of the spinal MRI images were conducted according to a standardized protocol by a single reader (JS). The intra-rater reliability was greater than Kappa values of 0.98. Pain measures included the seven-day prevalence of spine pain and neck pain, and average spine pain intensity due to spine pain during the past three months.

Results

We found 1,200 (36.8%) participants with at least one osseous lesion (2,080 lesions in total). Osseous lesions were less common in men than in women (35.5% vs 38.9%; P = .06). The prevalence of osseous lesions was highest at L2 in both sexes. The prevalence of osseous lesions increased with age. Up to eight osseous lesions were observed in a single subject. Hemangioma (28%), and lipoma (13%) occurred most often. Sclerosis (1.7%), aneurysmal bone cysts (0.7%), and blastoma (0.3%) were rare. Different osseous lesions occurred more often in combination with each other. The association with back or neck pain was mostly negligible.

Conclusion

Osseous lesions are common in the general population but of no clinical relevance for spinal pain. The prevalence of osseous lesions varied strongly across different regions of the spine and was also associated with age and gender. Our population-based data offer new insights and assist in judging the relevance of osseous lesions observed on MRIs of patients.

Klíčová slova:

Biology and life sciences – Anatomy – Musculoskeletal system – Spine – Vertebrae – Biochemistry – Lipids – Fats – Medicine and health sciences – Diagnostic medicine – Diagnostic radiology – Magnetic resonance imaging – Signs and symptoms – Lesions – Radiology and imaging – Pathology and laboratory medicine – Oncology – Cancers and neoplasms – Blastomas – Osteoblastoma – Surgical and invasive medical procedures – Autopsy – Research and analysis methods – Imaging techniques – Social sciences – Sociology – Education – Educational attainment – Standardized tests


Zdroje

1. Schmorl G., Junghanns H. Tumoren und Tumormetastasen. In: Schmorl G., Junghanns H., editors. Die gesunde und die kranke Wirbelsäule in Röntgenbild und Klinik. 5. Stuttgart: Thieme Georg Verlag; 1968. p. 556.

2. Töpfer D. Über ein infiltrierend wachsendes Hämangiom der Haut und mutiple Kapillarektsien der Haut und inneren Orgne: zur Kenntnis der Wirbelangiome Zeischrift für Pathologie. 1928;xxxvi.

3. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Annals of internal medicine. 2002;137(7):586–97. doi: 10.7326/0003-4819-137-7-200210010-00010 12353946.

4. Kasukurthi R, Ray WZ, Blackburn SL, Lusis EA, Santiago P. Intramedullary capillary hemangioma of the thoracic spine: case report and review of the literature. Rare tumors. 2009;1(1):e10. doi: 10.4081/rt.2009.e10 21139881; PubMed Central PMCID: PMC2994437.

5. Tehranzadeh J, Andrews C, Wong E. Lumbar spine imaging. Normal variants, imaging pitfalls, and artifacts. Radiologic clinics of North America. 2000;38(6):1207–53, v-vi. 11131630.

6. Barzin M., Maleki I. Incidence of Vertebral Hemangioma on Spinal Magnetic Resonance Imaging in Northern Iran. Pakistan Journal of Biological Sciences. 2009;12(6):542–4. 19580008

7. Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI, et al. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. AJR American journal of roentgenology. 2011;196(5):1151–5. doi: 10.2214/AJR.10.5457 21512084.

8. Is M, Gezen F, Alper M, Yildiz HK, Akyuz F. Epidural extension of a lumbar vertebral haemangioma. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia. 2006;13(6):687–90. doi: 10.1016/j.jocn.2005.09.014 16815019.

9. Inoue T, Miyamoto K, Kodama H, Hosoe H, Shimizu K. Total spondylectomy of a symptomatic hemangioma of the lumbar spine. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia. 2007;14(8):806–9. doi: 10.1016/j.jocn.2006.06.004 17577526.

10. Shilton H, Goldschlager T, Kelman A, Xenos C. Delayed post-traumatic capillary haemangioma of the spine. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia. 2011;18(11):1546–7. doi: 10.1016/j.jocn.2011.03.007 21871810.

11. Mahajan PS, Jayaram AP, Negi VC. Rare case of multiple aggressive vertebral hemangiomas. Journal of natural science, biology, and medicine. 2015;6(2):439–42. doi: 10.4103/0976-9668.160030 26283847; PubMed Central PMCID: PMC4518427.

12. Schrock WB, Wetzel RJ, Tanner SC, Khan MA. Aggressive hemangioma of the thoracic spine. Journal of radiology case reports. 2011;5(10):7–13. doi: 10.3941/jrcr.v5i10.828 22470764; PubMed Central PMCID: PMC3303463.

13. Tan S, Kurt A, Okutan O, Keskin S. CT findings of a thoracic vertebral hemangioma presenting with acute neurological symptoms. Turkish neurosurgery. 2011;21(1):113–5. 21294104.

14. Karaeminogullari O, Tuncay C, Demirors H, Akin K, Sahin O, Ozyurek A, et al. Multilevel vertebral hemangiomas: two episodes of spinal cord compression at separate levels 10 years apart. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2005;14(7):706–10. doi: 10.1007/s00586-005-0885-7 15856339; PubMed Central PMCID: PMC3489226.

15. Adeolu AA, Balogun JA, Adeleye AO, Adeoye PO, Okolo CA, Ogbole GI. Management of symptomatic vertebral haemangioma in a resource challenged environment. Child's nervous system: ChNS: official journal of the International Society for Pediatric Neurosurgery. 2010;26(7):979–82. doi: 10.1007/s00381-010-1101-6 20217099.

16. Fuwa S, Numaguchi Y, Kobayashi N, Saida Y. Percutaneous pediculoplasty for vertebral hemangioma involving the neural arch: a case report. Cardiovascular and interventional radiology. 2008;31(1):189–92. doi: 10.1007/s00270-006-0104-x 17171309.

17. Bivins E, Alidina JA, Bancroft LW. Aneurysmal bone cyst involving the c2 vertebra. Orthopedics. 2015;38(2):78, 141–3. doi: 10.3928/01477447-20150204-01 25665113.

18. Jouibari MF, Khoshnevisan A, Ghodsi SM, Nejat F, Naderi S, Abdollahzadeh S. Lumbar vertebral hemangioma with extradural extension, causing neurogenic claudication: a case report. Acta medica Iranica. 2011;49(10):697–700. 22071649.

19. Templin CR, Stambough JB, Stambough JL. Acute spinal cord compression caused by vertebral hemangioma. The spine journal: official journal of the North American Spine Society. 2004;4(5):595–600. doi: 10.1016/j.spinee.2003.08.034 15363434.

20. Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. Journal of neurosurgery. 1993;78(1):36–45. doi: 10.3171/jns.1993.78.1.0036 8416240.

21. Acosta FL Jr., Sanai N, Chi JH, Dowd CF, Chin C, Tihan T, et al. Comprehensive management of symptomatic and aggressive vertebral hemangiomas. Neurosurgery clinics of North America. 2008;19(1):17–29. doi: 10.1016/j.nec.2007.09.010 18156044.

22. Murugan L, Samson RS, Chandy MJ. Management of symptomatic vertebral hemangiomas: review of 13 patients. Neurology India. 2002;50(3):300–5. 12391457.

23. Mesfin A, McCarthy EF, Kebaish KM. Surgical treatment of aneurysmal bone cysts of the spine. The Iowa orthopaedic journal. 2012;32:40–5. 23576920; PubMed Central PMCID: PMC3565413.

24. Guarnieri G, Ambrosanio G, Vassallo P, Pezzullo MG, Galasso R, Lavanga A, et al. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up. Neuroradiology. 2009;51(7):471–6. doi: 10.1007/s00234-009-0520-0 19300988.

25. Vergel De Dios AM, Bond JR, Shives TC, McLeod RA, Unni KK. Aneurysmal bone cyst. A clinicopathologic study of 238 cases. Cancer. 1992;69(12):2921–31. doi: 10.1002/1097-0142(19920615)69:12<2921::aid-cncr2820691210>3.0.co;2-e 1591685.

26. Teekhasaenee C, Kita K, Takegami K, Kawakita E, Sakakibara T, Kasai Y. Intraosseous lipoma of the third lumbar spine: a case report. Journal of medical case reports. 2015;9:52. doi: 10.1186/s13256-015-0528-5 25889111; PubMed Central PMCID: PMC4357205.

27. Liu XW, Jin P, Wang LJ, Li M, Sun G. Vertebroplasty in the treatment of symptomatic vertebral haemangiomas without neurological deficit. European radiology. 2013;23(9):2575–81. doi: 10.1007/s00330-013-2843-9 23620368.

28. Ropper AE, Cahill KS, Hanna JW, McCarthy EF, Gokaslan ZL, Chi JH. Primary vertebral tumors: a review of epidemiologic, histological, and imaging findings, Part I: benign tumors. Neurosurgery. 2011;69(6):1171–80. doi: 10.1227/NEU.0b013e31822b8107 21725252.

29. Jones JO, Bruel BM, Vattam SR. Management of painful vertebral hemangiomas with kyphoplasty: a report of two cases and a literature review. Pain physician. 2009;12(4):E297–303. 19668288.

30. Mankin HJ, Hornicek FJ, Ortiz-Cruz E, Villafuerte J, Gebhardt MC. Aneurysmal bone cyst: a review of 150 patients. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2005;23(27):6756–62. doi: 10.1200/JCO.2005.15.255 16170183.

31. Hegenscheid K, Kuhn JP, Volzke H, Biffar R, Hosten N, Puls R. Whole-body magnetic resonance imaging of healthy volunteers: pilot study results from the population-based SHIP study. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 2009;181(8):748–59. doi: 10.1055/s-0028-1109510 19598074.

32. Volzke H, Alte D, Schmidt CO, Radke D, Lorbeer R, Friedrich N, et al. Cohort profile: the study of health in Pomerania. International journal of epidemiology. 2011;40(2):294–307. doi: 10.1093/ije/dyp394 20167617.

33. Schmidt CO, Alte D, Volzke H, Sauer S, Friedrich N, Valliant R. Partial misspecification of survey design features sufficed to severely bias estimates of health-related outcomes. J Clin Epidemiol. 2010;64(4):416–23. doi: 10.1016/j.jclinepi.2010.04.019 20926255

34. Hegenscheid K, Seipel R, Schmidt CO, Volzke H, Kuhn JP, Biffar R, et al. Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management. Eur Radiol. 2013;23(3):816–26. Epub 2012/08/23. doi: 10.1007/s00330-012-2636-6 22911290.

35. Von Korff M, Ormel J, Keefe F, Dworkin SF. Grading the severity of chronic pain. Pain. 1992;50 (2):133–49. doi: 10.1016/0304-3959(92)90154-4 1408309

36. Schmidt CO, Raspe H, Kohlmann T. Graded back pain revisited—do latent variable models change our understanding of severe back pain in the general population? Pain. 2010;149(1):50–6. doi: 10.1016/j.pain.2010.01.025 20185238

37. Schmidt CO, Kohlmann T. When to use the odds ratio or the relative risk? Int J Public Health. 2008;53(3):165–7. 19127890

38. Belotti F, Deb F, Manning WG, Norton EC. twopm: Two-part models. The Stata Journal. 2015;15(1):3–20.

39. Royston P, Sauerbrei W. Multivariable Model—Building: A Pragmatic Approach to Regression Anaylsis based on Fractional Polynomials for Modelling Continuous Variables. Chichester: John Wiley & Sons; 2008.

40. Brinjikji W, Diehn FE, Jarvik JG, Carr CM, Kallmes DF, Murad MH, et al. MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR American journal of neuroradiology. 2015;36(12):2394–9. doi: 10.3174/ajnr.A4498 26359154.

41. Endean A, Palmer KT, Coggon D. Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine. 2011;36(2):160–9. doi: 10.1097/BRS.0b013e3181cd9adb 20739918; PubMed Central PMCID: PMC3088902.

42. Campanacci M, Cervellati C, Donati U, Bertoni F. Aneurysmal bone cyst (a study of 127 cases, 72 with longterm follow up). Italian journal of orthopaedics and traumatology. 1976;2(3):341–53. 1031412.

43. Rodallec MH, Feydy A, Larousserie F, Anract P, Campagna R, Babinet A, et al. Diagnostic imaging of solitary tumors of the spine: what to do and say. Radiographics: a review publication of the Radiological Society of North America, Inc. 2008;28(4):1019–41. doi: 10.1148/rg.284075156 18635627.

44. Zhang M, Chen YR, Chang SD, Veeravagu A. CyberKnife stereotactic radiosurgery for the treatment of symptomatic vertebral hemangiomas: a single-institution experience. Neurosurgical focus. 2017;42(1):E13. Epub 2017/01/04. doi: 10.3171/2016.9.FOCUS16372 28041316.

45. Regev GJ, Salame K, Keynan O, Lidar Z. Resection of benign vertebral tumors by minimally invasive techniques. Spine Journal. 2015;15(11):2396–403. doi: 10.1016/j.spinee.2015.07.002 WOS:000364173900034. 26165474

46. Vassal F, Peoc'h M, Nuti C. Epidural capillary hemangioma of the thoracic spine with proximal nerve root involvement and extraforaminal extension. Acta neurochirurgica. 2011;153(11):2279–81. doi: 10.1007/s00701-011-1121-3 21822781.

47. Ayhan S, Palaoglu S, Geyik S, Saatci I, Onal MB. Concomitant intramedullary arteriovenous malformation and a vertebral hemangioma of cervical spine discovered by a pathologic fracture during bicycle accident. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2015;24(1):187–92. doi: 10.1007/s00586-014-3620-4 25351839.

48. Weaver SM, Kumar AB. Epithelioid hemangioma of the spine: an uncommon cause of spinal cord compression. Acta neurologica Belgica. 2015. doi: 10.1007/s13760-015-0437-9 25672266.

49. Martins MM, Francisco FA, de Paula RA, Parente DB. Epidural cavernous hemangioma of the spine: magnetic resonance imaging findings. Radiologia brasileira. 2015;48(1):62–3. doi: 10.1590/0100-3984.2013.0018 25798013; PubMed Central PMCID: PMC4366034.

50. Mugera C, Suh KJ, Huisman TA, Weber K, Belzberg AJ, Carrino JA, et al. Sclerotic lesions of the spine: MRI assessment. Journal of magnetic resonance imaging: JMRI. 2013;38(6):1310–24. doi: 10.1002/jmri.24247 24123379.


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