Clinical Outcomes of Vertebral Body Stenting for Osteoporotic Vertebral Fractures: Focus on Collapse Prevention and Magnetic Resonance Imaging-Based Indication

Study Design Retrospective observational study. Objectives To evaluate 1-year clinical outcomes of vertebral body stenting (VBS) for osteoporotic vertebral fractures (OVFs) and compare its effectiveness in patients with and without poor prognostic magnetic resonance imaging (MRI) findings. Methods Eighty-seven patients (mean age, 79.2 years) who underwent VBS for OVF were analyzed. Those with severe vertebral body injury requiring additional posterior fixation or unsuccessful stent deployment were excluded. Outcomes included changes in pain (Numerical Rating Scale [NRS]), perioperative complications, adjacent vertebral fractures (AVF), and development of non-union or delayed vertebral collapse. Radiographic parameters—anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), and vertebral angle (VA)—were assessed preoperatively, on postoperative day 1 (POD1), postoperative month 6 (POM6), and POM12. Patients were stratified based on the presence of poor prognostic MRI findings, defined as high or diffuse low-intensity signals on T2-weighted MRI. Results NRS significantly improved from 6.2 to 2.8 postoperatively. Cement leakage occurred without symptoms in 16% of patients. Non-union was not observed, and delayed vertebral collapse occurred without symptoms in three patients. Radiographic improvements in AVH, MVH, PVH, and VA were significant at POD1 and largely maintained at POM12. Patients with poor prognostic MRI findings showed significantly greater improvements in AVH, MVH, and VA at POD1 and POM12. Conclusions VBS effectively maintained vertebral height and prevented non-union and delayed collapse at 1 year postoperatively. Favorable outcomes were also seen in patients with poor prognostic MRI findings, supporting the utility of MRI as a treatment selection criterion.