• Line A Wickstrøm, Søren R Rafaelsen, Mikkel Ø Andersen, Andreas D K Andresen, Signe F Elmose, and Leah Carreon.
• Centre for Spine Surgery and Research, Region of Southern Denmark, Middelfart, Denmark.
• Spine. 2024 Sep 15; 49 (18): E300E305E300-E305.

Study DesignRetrospective quality improvement study.ObjectiveTo investigate if the rate of unsuspected malignancy in biopsies in patients with VCF who underwent percutaneous vertebroplasty (PVP) at the same orthopedic department has changed after the implementation of a new MRI scanning protocol.Summary Of Background DataDiscrimination between benign and malign vertebral compression fracture (VCF) can be difficult. However, early diagnosis of malignant VCF is crucial to further treatment and prognosis. An earlier study at an orthopedic department reported a rate of unsuspected malignancy of 4.9% in patients with VCF who underwent PVP when biopsies were obtained during the procedure. The MRI scanning protocol was changed in this period.MethodsRetrospective on 427 patients with vertebral compression fracture undergoing PVP from April 28, 2017 to April 28, 2022, identifying operated patients from the Danish national DaneSpine registry. Subsequently, individual clinical information was collected in journal records.ResultsThe rate of unsuspected malignancy was 0.9% (4/427), and the overestimation of malignant VCF was 50% (16/32).ConclusionDuring the last 5 years, the rate of unsuspected malignancy in patients with VCF undergoing PVP has improved considerably from 4.9% to 0.9%. Furthermore, MRI is over-diagnosing malignancies. Thus, the new scanning procedure is effective in differentiating between benign and malign VCFs.Level Of Evidence3.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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