Intradiscal cement leak following percutaneous vertebroplasty.
METHODS
A retrospective study to detect patients with cement leakage into the disc space following vertebroplasty.


OBJECTIVE
To determine the frequency, causes, and clinical significance of cement leakage into the disc space.


BACKGROUND
Much has been written about cement leakage into the epidural space following vertebroplasty but only little about intradiscal leakage.


METHODS
A total of 66 patients with 1 cemented osteoporotic, fractured vertebra between T5 and L5 were followed for at least 2 years. Two of the senior authors (Y.M. and A.P.) evaluated independently cement leakage into the disc space, possible causes were investigated, and the clinical results were evaluated according to patient self-assessment.


RESULTS
Detected in 27 patients, cement leakage into the disc space did not negatively affect patient satisfaction with the procedure. In 7 of these patients, leakage occurred through an intravertebral vacuum cleft and, in 8, through a perforation of the endplate created by the needle tip. In only 2 patients was cement found to cross the height of the vertebral body and leak into the contralateral disc.


CONCLUSIONS
Apart from iatrogenic endplate perforation, cement extravasation into the disc space was always found to occur through the fractured endplate or a vacuum cleft. Placing the needle tip far from the fractured endplate and using more solid cement appear to decrease the risk of leakage.
Mirovsky
Yigal
Y
Spine Unit, Assaf Harofeh Medical Center, Zerifin, Israel. Mirovsky@netvision.net.il
Anekstein
Yoram
Y
Shalmon
Ehud
E
Blankstein
Alexander
A
Peer
Amir
A
D000368:Aged; D001843:Bone Cements / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000473:pathology / Q000601:surgery; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome
D001843:Bone Cements