Analysis of intradiscal cement leakage during percutaneous vertebroplasty: Multivariate study of risk factors emphasizing preoperative MR findings

Suk-Joo Hong, Seunghun Lee, Joon Shik Yoon, Ju Han Kim, Youn-Kwan Park

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: Previous reports have shown that intradiscal cement leakage during percutaneous vertebroplasty (PVP) is related to several risk factors. The purpose of this study was to evaluate preoperative MRI scans for such risk factors. Methods: The study retrospectively analyzed 136 patients (aged 43-93 years; 234 vertebral bodies) with osteoporotic compression fractures. All patients underwent both MRI and PVP. There were 28 men (20.59%) and 108 women (79.41%). Age, gender, bone mineral density (BMD) score, endplate cortical disruption, abnormal T2-weighted hyperintensity in adjacent discs, presence of Kümmell's disease, linear body fracture with extension to endplate, level of treated vertebral body and injected cement volume were considered risk factors for intradiscal cement leakage. Results: Of the 234 vertebral bodies, 55 bodies from 42 patients with no endplate cortical disruption showed no adjacent intradiscal cement leakage. Of 179 bodies from 95 patients with endplate cortical disruption, 54 (30.17%) showed intradiscal cement leakage. Of the other possible risk factors, abnormal T2 hyperintensity in adjacent discs was significantly related to intradiscal cement leakage (P= 0.016). The other possible factors (age, gender, BMD score, Kümmell's disease, linear body fracture extending to the endplate, level of treated vertebral body and injected cement volume) were not related to intradiscal cement leakage. Conclusion: There was no adjacent intradiscal cement leakage without endplate cortical disruption. Abnormal T2 hyperintensity in adjacent discs may be related to intradiscal cement leakage, but only in the presence of endplate cortical disruption. Also, not having Kümmell's disease did not prevent intradiscal cement leakage. Thus, given these circumstances, careful cement injection is needed to reduce intradiscal cement leakage.

Original languageEnglish
Pages (from-to)195-201
Number of pages7
JournalJournal of Neuroradiology
Volume41
Issue number3
DOIs
Publication statusPublished - 2014 Jan 1

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Vertebroplasty
Bone Density
Compression Fractures
Osteoporotic Fractures
Age Factors
Magnetic Resonance Imaging
Injections

Keywords

  • Bone cement
  • MRI
  • Spine
  • Vertebroplasty

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

@article{598fc4958b324621b5bf104275a823a6,
title = "Analysis of intradiscal cement leakage during percutaneous vertebroplasty: Multivariate study of risk factors emphasizing preoperative MR findings",
abstract = "Objective: Previous reports have shown that intradiscal cement leakage during percutaneous vertebroplasty (PVP) is related to several risk factors. The purpose of this study was to evaluate preoperative MRI scans for such risk factors. Methods: The study retrospectively analyzed 136 patients (aged 43-93 years; 234 vertebral bodies) with osteoporotic compression fractures. All patients underwent both MRI and PVP. There were 28 men (20.59{\%}) and 108 women (79.41{\%}). Age, gender, bone mineral density (BMD) score, endplate cortical disruption, abnormal T2-weighted hyperintensity in adjacent discs, presence of K{\"u}mmell's disease, linear body fracture with extension to endplate, level of treated vertebral body and injected cement volume were considered risk factors for intradiscal cement leakage. Results: Of the 234 vertebral bodies, 55 bodies from 42 patients with no endplate cortical disruption showed no adjacent intradiscal cement leakage. Of 179 bodies from 95 patients with endplate cortical disruption, 54 (30.17{\%}) showed intradiscal cement leakage. Of the other possible risk factors, abnormal T2 hyperintensity in adjacent discs was significantly related to intradiscal cement leakage (P= 0.016). The other possible factors (age, gender, BMD score, K{\"u}mmell's disease, linear body fracture extending to the endplate, level of treated vertebral body and injected cement volume) were not related to intradiscal cement leakage. Conclusion: There was no adjacent intradiscal cement leakage without endplate cortical disruption. Abnormal T2 hyperintensity in adjacent discs may be related to intradiscal cement leakage, but only in the presence of endplate cortical disruption. Also, not having K{\"u}mmell's disease did not prevent intradiscal cement leakage. Thus, given these circumstances, careful cement injection is needed to reduce intradiscal cement leakage.",
keywords = "Bone cement, MRI, Spine, Vertebroplasty",
author = "Suk-Joo Hong and Seunghun Lee and Yoon, {Joon Shik} and Kim, {Ju Han} and Youn-Kwan Park",
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language = "English",
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T1 - Analysis of intradiscal cement leakage during percutaneous vertebroplasty

T2 - Multivariate study of risk factors emphasizing preoperative MR findings

AU - Hong, Suk-Joo

AU - Lee, Seunghun

AU - Yoon, Joon Shik

AU - Kim, Ju Han

AU - Park, Youn-Kwan

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective: Previous reports have shown that intradiscal cement leakage during percutaneous vertebroplasty (PVP) is related to several risk factors. The purpose of this study was to evaluate preoperative MRI scans for such risk factors. Methods: The study retrospectively analyzed 136 patients (aged 43-93 years; 234 vertebral bodies) with osteoporotic compression fractures. All patients underwent both MRI and PVP. There were 28 men (20.59%) and 108 women (79.41%). Age, gender, bone mineral density (BMD) score, endplate cortical disruption, abnormal T2-weighted hyperintensity in adjacent discs, presence of Kümmell's disease, linear body fracture with extension to endplate, level of treated vertebral body and injected cement volume were considered risk factors for intradiscal cement leakage. Results: Of the 234 vertebral bodies, 55 bodies from 42 patients with no endplate cortical disruption showed no adjacent intradiscal cement leakage. Of 179 bodies from 95 patients with endplate cortical disruption, 54 (30.17%) showed intradiscal cement leakage. Of the other possible risk factors, abnormal T2 hyperintensity in adjacent discs was significantly related to intradiscal cement leakage (P= 0.016). The other possible factors (age, gender, BMD score, Kümmell's disease, linear body fracture extending to the endplate, level of treated vertebral body and injected cement volume) were not related to intradiscal cement leakage. Conclusion: There was no adjacent intradiscal cement leakage without endplate cortical disruption. Abnormal T2 hyperintensity in adjacent discs may be related to intradiscal cement leakage, but only in the presence of endplate cortical disruption. Also, not having Kümmell's disease did not prevent intradiscal cement leakage. Thus, given these circumstances, careful cement injection is needed to reduce intradiscal cement leakage.

AB - Objective: Previous reports have shown that intradiscal cement leakage during percutaneous vertebroplasty (PVP) is related to several risk factors. The purpose of this study was to evaluate preoperative MRI scans for such risk factors. Methods: The study retrospectively analyzed 136 patients (aged 43-93 years; 234 vertebral bodies) with osteoporotic compression fractures. All patients underwent both MRI and PVP. There were 28 men (20.59%) and 108 women (79.41%). Age, gender, bone mineral density (BMD) score, endplate cortical disruption, abnormal T2-weighted hyperintensity in adjacent discs, presence of Kümmell's disease, linear body fracture with extension to endplate, level of treated vertebral body and injected cement volume were considered risk factors for intradiscal cement leakage. Results: Of the 234 vertebral bodies, 55 bodies from 42 patients with no endplate cortical disruption showed no adjacent intradiscal cement leakage. Of 179 bodies from 95 patients with endplate cortical disruption, 54 (30.17%) showed intradiscal cement leakage. Of the other possible risk factors, abnormal T2 hyperintensity in adjacent discs was significantly related to intradiscal cement leakage (P= 0.016). The other possible factors (age, gender, BMD score, Kümmell's disease, linear body fracture extending to the endplate, level of treated vertebral body and injected cement volume) were not related to intradiscal cement leakage. Conclusion: There was no adjacent intradiscal cement leakage without endplate cortical disruption. Abnormal T2 hyperintensity in adjacent discs may be related to intradiscal cement leakage, but only in the presence of endplate cortical disruption. Also, not having Kümmell's disease did not prevent intradiscal cement leakage. Thus, given these circumstances, careful cement injection is needed to reduce intradiscal cement leakage.

KW - Bone cement

KW - MRI

KW - Spine

KW - Vertebroplasty

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