title: Vertebral split fractures: technical feasibility of percutaneous vertebroplasty.
abstract: OBJECTIVE
  The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures.
  
  
  METHODS
  Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores.
  
  
  RESULTS
  Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P<0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P<0.001).
  
  
  CONCLUSIONS
  This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.
authors.affiliation: Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: huwart.laurent@wanadoo.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Huwart
authors.affiliation: Department of Biostatistics, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: pfoti@hotmail.fr.
authors.forename: Pauline
authors.initials: P
authors.lastname: Foti
authors.affiliation: Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: andreani.olivier@gmail.com.
authors.forename: Olivier
authors.initials: O
authors.lastname: Andreani
authors.affiliation: Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France. Electronic address: olivier.hauger@chubordeaux.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Hauger
authors.affiliation: Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: elodie.cervantes@live.fr.
authors.forename: Elodie
authors.initials: E
authors.lastname: Cervantes
authors.affiliation: Department of Radiology, Hôpital Princesse Grasse de Monaco, Monaco. Electronic address: pbrunner@chpg.mc.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunner
authors.affiliation: Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: boileau.p@chu-nice.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Boileau
authors.affiliation: Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France. Electronic address: amorettinicolas@yahoo.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Amoretti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D025321:Surgery, Computer-Assisted / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
keywords: CT and fluoroscopy guidance; Interventional radiology; Magerl A2; Percutaneous vertebroplasty; Split fracture