Cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with or without intravertebral clefts.
OBJECTIVE
The purpose of our study was to compare the incidence and location of cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with and without intravertebral clefts.


METHODS
Percutaneous vertebroplasty was performed in 120 consecutive patients with 300 osteoporotic compression fractures. The cement volume injected was recorded. The cement leakage was evaluated using spinal radiography, MRI, and fluoroscopy during the procedure and CT after the procedure.


RESULTS
One hundred seven vertebrae contained intervertebral clefts, and 193 vertebrae had no clefts. The cement volume injected (+/- SD) was 4.0 +/- 2.0 and 3.6 +/- 1.6 mL into vertebrae with clefts and without clefts, respectively, with no statistically significant difference (p = 0.14). There was no statistically significant difference in the incidence of cement leakage between vertebrae with clefts (53 of 107) and those without clefts (78 of 193) (p = 0.13). Leakage occurred into the epidural veins (12 of 107), perivertebral soft tissues (7 of 107), disks (41 of 107), intervertebral foramen (1 of 107), and spinal canal (1 of 107) in fractures with clefts and into the epidural veins (47 of 193), perivertebral soft tissues (13 of 193), disks (25 of 193), paravertebral veins (5 of 193), large vein (2 of 193), lung (2 of 193), intervertebral foramen (1 of 193), and spinal canal (1 of 193) in fractures without clefts. Cement leakage into the epidural vein was significantly more frequent in vertebrae without clefts (p < 0.01). Disk leakage was significantly more frequent in vertebrae with clefts compared with those without clefts (p < 0.01).


CONCLUSIONS
There was no statistically significant difference in the incidence of cement leakage between vertebrae with clefts and without clefts. However, cement leakage into the epidural vein was significantly more frequent in vertebrae without clefts and disk leakage was significantly more frequent in vertebrae with clefts.
Department of Radiology, Kansai Medical University, Hirakata Hospital, Hirakata, Osaka 573-1191, Japan. tanigano@hirakata.kmu.ac.jp
Noboru
N
Tanigawa
Shuji
S
Kariya
Atsushi
A
Komemushi
Takanori
T
Tokuda
Miyuki
M
Nakatani
Rie
R
Yagi
Satoshi
S
Sawada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D016009:Chi-Square Distribution; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis*; D005260:Female; D005471:Fluoroscopy; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty / Q000379:methods*
D001843:Bone Cements