Kyphosis Reduction and the Rate of Cement Leaks After Vertebroplasty of Intravertebral Clefts

Eur Radiol. 2006 May;16(5):1015-21. doi: 10.1007/s00330-005-0056-6. Epub 2005 Nov 29.

Abstract

To assess the results of vertebroplasty in patients with intravertebral clefts compared to patients with normal osteoporotic fractures, we evaluated the pre- and postoperative images and pain scores (VAS) of 114 patients with 192 vertebroplasty procedures treated between March 2002 and February 2005. Intravertebral clefts were identified on conventional radiographs, MR or CT images as gas- or fluid-filled spaces adjacent to an endplate of a fractured vertebra. Forty-four vertebrae showed intravertebral clefts. All clefts were filled with PMMA showing a typical filling pattern. Due to the prone positioning of the patient during vertebroplasty, a significant reduction of the kyphosis angle was achieved in the cleft group. Cement leakage occurred in 18.2% of clefts and 46% of regular osteoporotic fractures. In all patients, good filling of the cleft was achieved no matter where the needle tip was placed in the vertebra. The VAS score was 9.1 preoperatively, 3.6 before discharge and 3.9 6 months postoperatively, showing no significant difference between both groups. Patients with intravertebral clefts show a significant reduction of the kyphosis angle compared to non-cleft patients and have a significantly lower risk of experiencing cement leakage during vertebroplasty. Pain reduction is the same in both groups.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Bone Cements / adverse effects*
  • Female
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / surgery
  • Fractures, Spontaneous / diagnostic imaging
  • Fractures, Spontaneous / surgery
  • Humans
  • Incidence
  • Kyphosis / diagnostic imaging
  • Kyphosis / pathology
  • Kyphosis / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Male
  • Minimally Invasive Surgical Procedures
  • Osteoporosis / complications*
  • Osteoporosis / diagnostic imaging
  • Pain / diagnostic imaging
  • Pain / etiology
  • Pain Measurement
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology*
  • Spinal Fractures / pathology
  • Spinal Fractures / surgery*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Bone Cements