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Importance of Intravertebral Fracture Clefts in Vertebroplasty Outcome

Matthew C. Wiggins1,2, Mehrdad Sehizadeh1,3, Thomas K. Pilgram1 and Louis A. Gilula1

1 All authors: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd., Campus Box 8131, St. Louis, MO 63110.
2 Present address: Lancaster Radiology Associates, Lancaster, PA.
3 Present address: Advanced Diagnostic Imaging, Belleville, IL.


Figure 1
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  		Fig. 1A —71-year-old woman with vertebral compression fracture after fall. Frontal (A) and lateral (B) radiographs of lumbar spine show loss of vertebral body height and linear well-demarcated radiolucency characteristic of intravertebral fracture cleft (arrows).

 

Figure 2
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  		Fig. 1B —71-year-old woman with vertebral compression fracture after fall. Frontal (A) and lateral (B) radiographs of lumbar spine show loss of vertebral body height and linear well-demarcated radiolucency characteristic of intravertebral fracture cleft (arrows).

 

Figure 3
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  		Fig. 1C —71-year-old woman with vertebral compression fracture after fall. Axial CT scan at level of A and B shows intravertebral gas.

 

Figure 4
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  		Fig. 2 —69-year-old woman with osteoporotic vertebral compression fracture. Sagittal T2-weighted MR image shows well-demarcated focus of T2 hyperintensity similar to that of adjacent CSF and characteristic of intravertebral fracture cleft (arrows).

 

Figure 5
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  		Fig. 3A —81-year-old man with vertebral compression fracture after lifting garage door. Lateral fluoroscopic spot radiograph before injection of cement shows subtle radiolucency indicative of fracture cleft (arrows).

 

Figure 6
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  		Fig. 3B —81-year-old man with vertebral compression fracture after lifting garage door. Fluoroscopic spot radiograph after injection of cement shows immediate characteristic opacification of cleft with dense filling of geographic, well-demarcated intravertebral cavity (arrows).

 

Figure 7
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  		Fig. 3C —81-year-old man with vertebral compression fracture after lifting garage door. Frontal fluoroscopic spot radiograph shows cleft (arrows) extending across vertebral body remains well demarcated.

 

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