Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures

J Bone Joint Surg Br. 2003 Jan;85(1):83-9. doi: 10.1302/0301-620x.85b1.13026.


e analysed the CT scans and radiographs of 76 vertebrae in 49 patients who underwent vertebroplasty for painful osteoporotic compression fractures. Leaks of cement were classified into three types: those via the basivertebral vein (type B), via the segmental vein (type S), and through a cortical defect (type C). More leaks were identified on CT scans than on radiographs by a factor of 1.5 (74/49). Most type-B (93%) and type-S (86%) leaks were missed or underestimated on a lateral radiograph which is usually the only view used during the injection of cement. Of the leaks into the spinal canal, only 7% (2/28) were correctly identified on radiographs. The areas on lateral radiographs where this type of leak may be observed were divided into four zones, and their diagnostic value in predicting a leak into the spinal canal was evaluated. The results showed that cement in the neural foramina had the highest positive predictive value (86%).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Cements*
  • Female
  • Fractures, Spontaneous / diagnostic imaging
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / surgery*
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / complications*
  • Pain / etiology
  • Pain / prevention & control
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology
  • Spinal Fractures / surgery*
  • Tomography, X-Ray Computed / methods


  • Bone Cements