title: Kyphosis reduction and the rate of cement leaks after vertebroplasty of intravertebral clefts.
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.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Klinikum Sued, Breslauer Str. 201, 90471 Nuernberg, Germany. Martin.Krauss@klinikum-nuernberg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Krauss
authors.forename: Horst
authors.initials: H
authors.lastname: Hirschfelder
authors.forename: Bernd
authors.initials: B
authors.lastname: Tomandl
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lichti
authors.forename: Ingrid
authors.initials: I
authors.lastname: Bär
mesh_terms: D000368:Aged; D001843:Bone Cements / Q000009:adverse effects*; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D015994:Incidence; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging; D010146:Pain / Q000000981:diagnostic imaging / Q000209:etiology; D010147:Pain Measurement; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements