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Cement Leakage During Vertebroplasty Can Be Predicted on Preoperative MRI

¹ Division of Diagnostic and Interventional Neuroradiology, Department of Imaging Services, University of Rochester Medical Center, Rochester, NY.
² Present address: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
³ Present address: Department of Radiology, Showa University School of Medicine, Tokyo, Japan.
⁴ Present address: Department of Oral and Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka, Japan.

OBJECTIVE. Previous studies have shown that cement leakage into an adjacent disk space is a risk factor for new fracture after vertebroplasty. The purpose of this study was to investigate the use of preoperative MRI for predicting such cement leakage.

MATERIALS AND METHODS. Our institutional review board approved this retrospective study and waived the requirement of informed consent. We studied preoperative MRI of 46 vertebroplasty patients (107 vertebral bodies). Endplate cortical defect, abnormal T2 hyperintensity in adjacent disk space, intravertebral cleft, degree of compression, and wedge angle were correlated to the incidence of cement leakage into the adjacent disk. Patient age, sex, and location of treated vertebral body were also evaluated. We used logistic regression analysis and Fisher's exact probability test to analyze the association between cement leakage and these observations.

RESULTS. Cortical defect in the endplate of the treated vertebral body, abnormal T2 hyperintensity in the adjacent intervertebral disk, and absence of intravertebral cleft were associated with cement leakage into the disk space (p < 0.05). There was no statistically significant association between cement leakage into the disk and degree of compression, wedge angle, location of treated vertebral body, patient age, or sex (p >0.05).

CONCLUSION. Cement leakage into an adjacent disk is more common when there is a cortical defect in the endplate and increased T2 signal in the adjacent disk and is less common if there is an intravertebral cleft.

Keywords: CT • MRI • spine • vertebroplasty

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This article has been cited by other articles:

				A. Hiwatashi and P.-L. Westesson Reply to Preoperative MR Findings Predictive of Cement Leakage During Vertebroplasty: Low Signal Intensity Linear Lesion in Intervertebral Disk Am. J. Roentgenol., February 1, 2008; 190(2): W165 - W165. [Full Text] [PDF]

				D. S. Yoo, Y. M. Kim, and Y. S. Lee Preoperative MR Findings Predictive of Cement Leakage During Vertebroplasty: Low Signal Intensity Linear Lesion in Intervertebral Disk Am. J. Roentgenol., November 1, 2007; 189(5): W302 - W302. [Full Text] [PDF]