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Outcomes of Augmentation in Osteoporotic Vertebral Compression Fractures Showing a Cleft Sign on MRI

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Introduction

Intravertebral clefts (IVCs) typically occur in association with osteoporotic vertebral compression fractures (OVCFs) and can be characterized based on magnetic resonance imaging (MRI). This study aimed to identify the clinical characteristics of IVCs with different MRI signals and assess their influence on outcomes of vertebral augmentation.

Materials and Methods

We retrospectively recruited patients with OVCFs and associated IVCs who underwent vertebral augmentation. Patients were stratified into two groups based on whether the IVCs were full of liquid or gas, as determined by MRI signals. Patients were also stratified based on whether vertebral augmentation involved percutaneous kyphoplasty (PKP) or vertebroplasty (PVP). Pre- and postprocedural parameters were compared between groups.

Results

A total of 194 fractured vertebrae (86 liquid-filled, 108 gas-filled) were examined. Scores for bone cement distribution were significantly higher in the gas group than in the liquid group, indicating broader cement distribution in the gas group. In both groups, intervention significantly improved pain and mobility scores. Among patients with gas-filled IVCs, the incidence of bone cement leakage and recollapse of treated vertebrae were significantly higher after PKP than after PVP. In the liquid group, incidence of bone cement leakage and recollapse of treated vertebrae did not differ significantly between patients who received PKP or PVP.

Conclusion

Vertebral augmentation is effective for treating OVCFs with gas- or liquid-filled IVCs. However, in patients with gas-filled IVCs, PKP may be associated with higher incidence of cement leakage and recollapse of treated vertebrae than PVP. Liquid-filled IVCs may not promote bone cement distribution.

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Funding

This study was funded by the Science and Technology Support Program of Sichuan Province (Grant Number JH2018055).

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Authors and Affiliations

  1. Department of Radiology, Sichuan University West China Hospital, Guoxue Xiang, No. 37, Chengdu, 610041, China

    Jing Tang & Bin Song

  2. Department of Orthopedics, Chengdu First People’s Hospital, Wanxiang North Road, No.18, Chengdu, 610000, China

    Jin Liu & Zuchao Gu

Authors
  1. Jing Tang
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  2. Jin Liu
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  4. Bin Song
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Correspondence to Jin Liu or Bin Song.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Tang, J., Liu, J., Gu, Z. et al. Outcomes of Augmentation in Osteoporotic Vertebral Compression Fractures Showing a Cleft Sign on MRI. Cardiovasc Intervent Radiol 44, 428–435 (2021). https://doi.org/10.1007/s00270-020-02753-6

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  • DOI: https://doi.org/10.1007/s00270-020-02753-6

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