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Height restoration and wedge angle correction effects of percutaneous vertebroplasty: association with intraosseous clefts

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Abstract

Objective

To evaluate effects of vertebroplasty on restoration of vertebral body height and wedge angle and relief from pain in patients with osteoporotic compression fractures.

Methods

A retrospective study of 156 patients (232 levels) who had undergone vertebroplasty was conducted. Treated vertebrae with cleft included 49 patients (49 levels) and that without cleft 107 patients (183 levels). Effects on restoration of vertebral body height and wedge angle, and pain scores between pre- and post-procedure were statistically analyzed by using a paired-sample t test, and Kruskal Wallis test.

Results

The height and wedge angle of the fractured vertebral body, and pain score, improved significantly after vertebroplasty. On a vertebra-by-vertebra analysis, the vertebral body height and wedge angle in the cleft group, were statistically significantly better post-procedure (P < 0.01); in the non-cleft group, there was nosignificant improved (P > 0.05). Pain relief was not statistically significant different between the two groups (P > 0.05).

Conclusion

Most patients experienced pain relief after vertebroplasty. After vertebroplasty, the height and wedge angle were significantly improved in the cleft group (p < 0.01), with no significant improvement in the non-cleft group (p > 0.05).

Key Points

• Vertebra with cleft is attributed to improvement of the spinal deformity

• Vertebra without cleft was not associated with improvement of the spinal deformity

• Vertebroplasty is an effective treatment strategy for osteoporotic compression fractures

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References

  1. Diamond TH, Bryant C, Browne L, Clark WA (2006) Clinical outcomes after acute osteoporotic vertebral fractures: a 2-year non-randomised trial comparing percutaneous vertebroplasty with conservative therapy. Med J Aust 184:113–117

    PubMed  Google Scholar 

  2. Hochmuth K, Proschek D, Schwarz W, Mack M, Kurth AA, Vogl TJ (2006) Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review. Eur Radiol 16:998–1004

    Article  PubMed  CAS  Google Scholar 

  3. Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976) 25:923–928

    Article  CAS  Google Scholar 

  4. Masala S, Mastrangeli R, Petrella MC, Massari F, Ursone A, Simonetti G (2009) Percutaneous vertebroplasty in 1,253 levels: results and long-term effectiveness in a single centre. Eur Radiol 19:165–171

    Article  PubMed  Google Scholar 

  5. McKiernan F, Jensen R, Faciszewski T (2003) The dynamic mobility of vertebral compression fractures. J Bone Miner Res 18:24–29

    Article  PubMed  Google Scholar 

  6. Hiwatashi A, Moritani T, Numaguchi Y, Westesson PL (2003) Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol 24:185–189

    PubMed  Google Scholar 

  7. Teng MM, Wei CJ, Wei LC, Luo CB, Lirng JF, Chang FC, Liu CL, Chang CY (2003) Kyphosis correction and height restoration effects of percutaneous vertebroplasty. AJNR Am J Neuroradiol 24:1893–1900

    PubMed  Google Scholar 

  8. Carlier RY, Gordji H, Mompoint DM, Vernhet N, Feydy A, Vallée C (2004) Osteoporotic vertebral collapse: percutaneous vertebroplasty and local kyphosis correction. Radiology 233:891–898

    Article  PubMed  Google Scholar 

  9. Dublin AB, Hartman J, Latchaw RE, Hald JK, Reid MH (2004) The vertebral body fracture in osteoporosis: restoration of height using percutaneous vertebroplasty. AJNR Am J Neuroradiol 26:489–492

    Google Scholar 

  10. Hiwatashi A, Westesson PL, Yoshiura T, Noguchi T, Togao O, Yamashita K, Kamano H, Honda H (2009) Kyphoplasty and vertebroplasty produce the same degree of height restoration. AJNR Am J Neuroradiol 30:669–673

    Article  PubMed  CAS  Google Scholar 

  11. Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H (1998) Percutaneous vertebroplasty: state of the art. RadioGraphics 18:311–320, discussion 320–313

    PubMed  CAS  Google Scholar 

  12. Deramond H, Depriester C, Toussaint P, Galibert P (1997) Percutaneous vertebroplasty. Semin Musculoskelet Radiol 1:285–296

    Article  PubMed  Google Scholar 

  13. Jensen ME, Dion JE (2000) Percutaneous vertebroplasty in the treatment of osteoporotic compression fractures. Neuroimaging Clin N Am 10:547–568

    PubMed  CAS  Google Scholar 

  14. Theodorou DJ (2000) The intravertebral vacuum cleft sign. Radiology 221:787–788

    Article  Google Scholar 

  15. Malghem J, Maldague B, Labaisse MA, Dooms G, Duprez T, Devogelaer JP, Vande BB (1993) Intravertebral vacuum cleft: changes in content after supine positioning. Radiology 187:483–487

    PubMed  CAS  Google Scholar 

  16. Lane JI, Maus TP, Wald JT, Thielen KR, Bobra S, Luetmer PH (2002) Intravertebral clefts opacified during vertebroplasty: pathogenesis, technical implications, and prognostic significance. AJNR Am J Neuroradiol 23:1642–1646

    PubMed  Google Scholar 

  17. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 18:1897–1904

    PubMed  CAS  Google Scholar 

  18. Sun G, Jin P, Li M, Lu Y, Liu X, Li F, Xie Z, Ding J, Peng Z (2011) Percutaneous vertebroplasty for pain management in spinal metastasis with epidural involvement. Technol Cancer Res Treat 10:267–274

    PubMed  CAS  Google Scholar 

  19. Ratliff J, Nguyen T, Heiss J (2001) Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine (Phila Pa 1976) 26:E300–E302

    Article  CAS  Google Scholar 

  20. Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26:1511–1515

    Article  PubMed  CAS  Google Scholar 

  21. Phillips FM, Wetzel FT, Lieberman I, Campbell-Hupp M (2002) An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 27:2173–2178

    Article  PubMed  Google Scholar 

  22. Dudeney S, Lieberman IH, Reinhardt MK, Hussein M (2002) Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma. J Clin Oncol 20:2382–2387

    Article  PubMed  CAS  Google Scholar 

  23. Kasperk C, Hillmeier J, Nöldge G, Grafe IA, Dafonseca K, Raupp D, Bardenheuer H, Libicher M, Liegibel UM, Sommer U, Hilscher U, Pyerin W, Vetter M, Meinzer HP, Meeder PJ, Taylor RS, Nawroth P (2005) Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Res 20:604–612

    Article  PubMed  Google Scholar 

  24. Ledlie JT, Renfro MB (2006) Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spin (Phila Pa 1976) 31:57–64

    Article  Google Scholar 

  25. Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fracture. Spine 26:1631–1637

    Article  PubMed  CAS  Google Scholar 

  26. Wang G, Yang H, Chen K (2010) Osteoporotic vertebral compression fractures with an intravertebral cleft treated by percutaneous balloon kyphoplasty. J Bone Joint Surg Br 92:1553–1557

    Article  PubMed  CAS  Google Scholar 

  27. Kim MJ, Lindsey DP, Hannibal M, Alamin TF (2006) Vertebroplasty versus kyphoplasty: biomechanical behavior under repetitive loading conditions. Spine 31:2079–2084

    Article  PubMed  Google Scholar 

  28. Cawley DT, Sexton P, Murphy T, McCabe JP (2011) Optimal patient positioning for ligamentotaxis during balloon kyphoplasty of the thoracolumbar and lumbar spine. J Clin Neurosci 18:834–836

    Article  PubMed  CAS  Google Scholar 

  29. Kim YJ, Lee JW, Kim KJ, Chung SK, Kim HJ, Park JM, Kang HS (2010) Percutaneous vertebroplasty for intravertebral cleft: analysis of therapeutic effects and outcome predictors. Skeletal Radiol 39:757–766

    Article  PubMed  Google Scholar 

  30. Peh WCG, Gelbart MS, Gilula LA, Peck DD (2003) Percutaneous vertebroplasty: treatment of painful vertebral compresson fractures with intraosseous vacuum phenomena. AJR Am J Roentgenol 180:1411–1417

    PubMed  Google Scholar 

  31. Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568

    Article  PubMed  CAS  Google Scholar 

  32. Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579

    Article  PubMed  CAS  Google Scholar 

  33. Belkoff SM, Mathis JM, Jasper LE, Deramond H (2001) The biomechanics of vertebroplasty: the effect of cement volume on mechanical behavior. Spine 26:1537–1541

    Article  PubMed  CAS  Google Scholar 

  34. Tohmeh AG, Mathis JMD, Fenton C, Levine AM, Belkoff SM (1999) Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures. Spine 24:1772–1776

    Article  PubMed  CAS  Google Scholar 

  35. Molloy S, Riley LH 3rd, Belkoff SM (2005) Effect of cement volume and placement on mechanical-property restoration resulting from vertebroplasty. AJNR Am J Neuroradiol 26:401–404

    PubMed  Google Scholar 

  36. Rüger M, Schmoelz W (2009) Vertebroplasty with highviscosity polymethylmethacrylate cement facilitates vertebral body restoration in vitro. Spine 34:2619–2625

    Article  PubMed  Google Scholar 

  37. Ryu KS, Park CK, Kim MC, Kang JK (2002) Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. J Neurosurg 96:56–61

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Imaging, Jinan Military General Hospital, 25 Shifan Rd., Jinan, Shandong Province, China, 250031

    Gang Sun, Peng Jin, Min Li, Xun-wei Liu & Fan-dong Li

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  1. Gang Sun
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  2. Peng Jin
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  3. Min Li
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  4. Xun-wei Liu
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  5. Fan-dong Li
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Correspondence to Gang Sun.

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Sun, G., Jin, P., Li, M. et al. Height restoration and wedge angle correction effects of percutaneous vertebroplasty: association with intraosseous clefts. Eur Radiol 21, 2597–2603 (2011). https://doi.org/10.1007/s00330-011-2218-z

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  • DOI: https://doi.org/10.1007/s00330-011-2218-z

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