title: Percutaneous balloon kyphoplasty of osteoporotic vertebral compression fractures with intravertebral cleft.
abstract: BACKGROUND
  Intravertebral cleft is a structural change in osteoporotic vertebral compression fractures (OVCF), which is the manifestation of ischemic vertebral osteonecrosis complicated with fracture nonunion and pseudoarthrosis and appears in the late stage of OVCF. Despite numerous studies on OVCF, few aim to evaluate the clinicoradiological characteristics and clinical significance of intravertebral cleft in OVCF. This study investigates clinicoradiological characteristics of intravertebral cleft in OVCF and the effect on the efficacy of percutaneous balloon kyphoplasty (PKP).
  
  
  METHODS
  PKP was performed on 139 OVCF patients without intravertebral cleft (group A) and 44 OVCF patients with intravertebral cleft (group B). The frequency distribution of the affected vertebral body, bone cement infusion volume, imaging manifestation, leakage rate and type, preoperative and postoperative height of the affected vertebral body, visual analog scale (VAS) and Oswestry disability index (ODI) score were evaluated.
  
  
  RESULTS
  Significant differences were found in the frequency distribution of the affected vertebral body and bone cement leakage type between the two groups (P < 0.05). However, differences in bone cement infusion volume and leakage rate (P > 0.05) were not detected. In both groups, the postoperative height of the affected vertebral body was significantly improved (P < 0.05). The restoration of vertebral body height in group B was more evident than that in group A (P < 0.05). The preoperative VAS and ODI scores in group B were significantly higher than those in group A (P < 0.05). After surgical treatment, pain relief and daily activity function in both groups were significantly improved (P < 0.05), and no significant difference in postoperative scores was detected between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Intravertebral cleft exhibits specific clinical and imaging as well as bone cement formation characteristics. PKP can effectively restore the affected vertebral body height, alleviate pain, and improve daily activity function of patients.
authors.affiliation: Department of Orthopedics, Jiaxing Second Hospital, Jiaxing 314000, China.
authors.forename: Bao
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310016, China.
authors.forename: Shunwu
authors.initials: S
authors.lastname: Fan
authors.affiliation: Department of Orthopedics, Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310016, China.
authors.forename: Fengdong
authors.initials: F
authors.lastname: Zhao
keywords: Intravertebral cleft; osteoporosis vertebral compression fracture; percutaneous kyphoplasty