J Korean Soc Spine Surg.  2006 Sep;13(3):184-190. 10.4184/jkss.2006.13.3.184.

MR Predictors of Bone Cement Leakage in Percutaneous Vertebroplasty and Kyphoplasty for Painful Osteoporotic Vertebral Compression Fracture

• Jun DS
• Shin WJ
• Koh YH
• Moon SH

• KMID: 2209640
• DOI: http://doi.org/10.4184/jkss.2006.13.3.184

Abstract

STUDY DESIGN: Retrospective study
OBJECTIVES
To determine MR findings that affect the bone cement leakage in patients with osteoporotic compressive fractures who are receiving percutaneous vertebroplasties and kyphoplasties.
MATERIALS AND METHODS
A retrospective review was conducted on 105 patients with 131 vertebrae treated by percutaneous vertebroplasties (group 1: 66 patients and 78 cases) and kyphoplasties (group 2: 39 patients and 53 cases) from October 2001 to October 2005. The study was performed to determine whether cement leakage was related to any of the following MR findings: level of injured vertebra, severity of anterior height loss, posterior cortical disruption, endplate disruption, presence of either vacuum or cystic portions, linear sclerosis that was low in signal intensity in T1 and T2-weighted images.
RESULTS
Bone cement leakage was detected in 51 (65.3%) of 78 treated vertebrae in group 1 and 18 (33.9%) of 53 treated vertebrae in group 2. There was a statistically significant difference between the incidences (p<0.05). Vertebral endplate disruption had a positive correlation in both groups (p<0.05). There was more cement leakage in group 1 (48.5%) than in group 2 (18.1%) in cases of endplate disruption (p<0.05). Vacuum or cystic change had negative correlations to bone cement leakage in group 1 (p<0.05). No other MR findings demonstrated a statistically significant correlation with bone cement leakage.
CONCLUSION
On the MR findings, vertebral endplate disruption and vacuum or cystic change in fractured vertebrae demonstrated a significant correlation with bone cement leakage in group 1. There was relatively less cement leakage into the intervertebral spaces with kyphoplasties than with vertebroplasties in the cases of vertebral endplate disruption.

Keyword

Osteoporotic compressive fracture; Vertebroplasty; Kyphoplasty; Bone cement leakage

MeSH Terms

Fractures, Compression*
Humans
Incidence
Kyphoplasty*
Retrospective Studies
Sclerosis
Spine
Vacuum
Vertebroplasty*

Figure

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  Fig. 1. (A) The patient who is 75 years old female. She slipped down and complained back pain. Magnetic resonance images of tho-racic vertebra. T1 & T2 weighted images show a vertebral body signal change, vertebral anterior height loss and disruption of upper endplate (B) Intraoperative radiographs of injured vertebra treated with vertebroplasty show a leakage of bone cement into the intervertebral space.

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  Fig. 2. (A) The patient who is 78 years old female. She slipped down and complained back pain. Magnetic resonance images of lum-bar vertebra. T1 & T2 weighted images show a vertebral body signal change, vertebral anterior height loss and disruption of upper endplate. (B). Postoperative radiographs of injured vertebra treated with kyphoplasty show a no leakage of bone cement via disrupted upper endplate.

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