Korean J Neurotrauma.  2012 Apr;8(1):15-20. 10.13004/kjnt.2012.8.1.15.

The Differences of Radiological Results after Percutaneous Vertebroplasty according to the Degree of Preoperative Canal Encroachment due to Bony Fragments

• Hong SM
• Kim TW
• Park KH
• Chi MP
• Kim JO

• KMID: 1427677
• DOI: http://doi.org/10.13004/kjnt.2012.8.1.15

Abstract

OBJECTIVE
Anterior wedge compression fractures and burst fractures have different clinical features, treatment methods and risks of neurologic deficits. The aim of this study was to evaluate the radiological differences and postoperative risk due to cement leakage after vertebroplasty.
METHODS
From January 2007 to December 2008, we retrospectively analyzed the radiological features of 43 patients. We divided the patients into three groups by the degree of the displaced bony fragments into the spinal canal. The change of the compression ratio, the kyphotic angle, the presence of cement leakage and the occurrence of major complications were investigated.
RESULTS
The immediately postoperative improvement of the compression ratio was significantly better in the anterior wedge compression fracture group than that in the burst compression group (p-value: 0.022). Cement leakage was more common in the burst fracture group even though this was not statistically significant (p-value: 0.114), but cement leakage into spinal canal did not occur. There was no major complication, including embolism and additional neurologic deficit, after vertebroplasty in all the patients.
CONCLUSION
Vertebroplasty was the more effective method for treating an anterior wedge fracture than a burst fracture, and especially for achieving an improved compression ratio. Even though the risk of cement leakage may be higher for a burst fracture, vertebroplasty may be also carefully applied to burst fracture patients with no neurologic deficits at admission.

Keyword

Compression fracture; Spinal cord compression; Vertebroplasty; Cement leakage

MeSH Terms

Embolism
Fractures, Compression
Humans
Neurologic Manifestations
Retrospective Studies
Spinal Canal
Spinal Cord Compression
Vertebroplasty

Figure

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  FIGURE 1. Preoperative lumbar CT shows the degree of canal encroachment due to bony fragment. None (A), less than 20% (B), more than 20% (C).

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  FIGURE 2. Preoperative lumbar CT and axial MRI image shows canal encroachment more than 20% (A, B). Simple X-ray lateral view after vertebroplasty (C).

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