J Korean Soc Spine Surg.  2016 Mar;23(1):25-30. 10.4184/jkss.2016.23.1.25.

Radiological Follow-up Results of Cemented Vertebrae after Vertebroplasty

• Kim JH

• KMID: 2161009
• DOI: http://doi.org/10.4184/jkss.2016.23.1.25

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
To assess radiological follow-up results, including progression of bone cement augmented vertebrae, of patients who underwent percutaneous vertebroplasty (PVP). SUMMARY OF LITERATURE REVIEW: There are few studies of radiological follow-up results that include progression of bone cement augmented vertebrae after PVP, regardless of good clinical results.
MATERIALS AND METHODS
Between January 2000 and August 2007, 253 patients were treated with PVP for osteoporotic compression fracture. Among them, 81 patients died during follow-up and 101 patients (157 vertebrae) were available for follow-up over 7 years. We analyzed the radiologic outcomes, focusing on augmented bone cement feature and progressive change with adjacent vertebrae.
RESULTS
The mean follow-up period was 7.9 years. Anterior body height in the last follow-up was improved about 0.3 mm compared with the preprocedural value, but this improvement was not statistically significant. The focal kyphotic angle was reduced from 12.3° at the preprocedural state to 11.7° at the postprocedural state but this change was also not statistically significant (p>0.05). Out of the 101 cases, we observed 7 cases of radiolucent line with decreased bone density in the adjacent area of bone cement and 5 cases of bone cement cracks accompanied with vertebral collapse were observed. Eleven patients (10.8%) had a solid spontaneous fusion, and 8 patients (7.9%) had partially fused with adjacent vertebrae.
CONCLUSIONS
The bone cement augmented vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle. After percutaneous vertebroplasty, unpredictable spontaneous fusion with proximal adjacent vertebrae developed at a higher rate than 10% rate.

Keyword

Osteoporotic vertebral compression fracture; Bone cement; Radiological follow-up results; Spontaneous fusion; Vertebroplasty

MeSH Terms

Body Height
Bone Density
Follow-Up Studies*
Fractures, Compression
Humans
Retrospective Studies
Spine*
Vertebroplasty*

Figure

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  Fig. 1. A solid fusion group defined fractured vertebrae in which continuity was achieved in at least 3 adjacent cortical vertebrae. The white ar-row shows cortical continuity between vertebrae.

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  Fig. 2. (A) A 71-year-old women had a vertebroplasty for T12 osteoporotic compression fracture. (B) The eight-year follow-up revealed a radiolucent area (arrow) between cement and bone on plain image.

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  Fig. 3. (A) Seventy years old woman had osteoporotic compression fracture of L1 and L2. (B) She underwent percutaneous vertebroplasty on both L1 and L2, (C) During the two-year postoperative follow-up, an X-ray showed increased focal kyphotic angle between L1 and L2, (D) During the six-year postoperative follow-up, an X-ray showed a marked increased kyphotic angle and cemented vertebrae breakage at L1 and L2.

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