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Cement Leakage During Vertebroplasty Can Be Predicted on Preoperative MRI

Akio Hiwatashi1,2, Yoshimitsu Ohgiya1,3, Naoya Kakimoto1,4 and Per-Lennart Westesson1

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.


Figure 1
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  		Fig. 1A —68-year-old woman with history of long-term steroid use for chronic obstructive lung disease. Sagittal T2-weighted image before vertebroplasty shows compression fracture of T11 vertebral body with concave deformity. Cortical defect is noted in superior endplate (arrow). Hyperintensity is noted in adjacent desiccated intervertebral disks, which is more prominent at T10-T11 (arrowhead).

 

Figure 2
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  		Fig. 1B —68-year-old woman with history of long-term steroid use for chronic obstructive lung disease. Sagittal reformatted CT image after vertebroplasty shows cement leakage in T10-T11 disk space (arrow) through cortical defect seen on preoperative MR image.

 

Figure 3
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  		Fig. 2A —90-year-old woman with lower back pain. Sagittal T2-weighted image before vertebroplasty shows mild compression fracture of T12 vertebral body. No prominent cortical defect or abnormal high signal in adjacent disk is noted. Intravertebral cleft is noted in inferior portion of vertebral body (arrow).

 

Figure 4
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  		Fig. 2B —90-year-old woman with lower back pain. Sagittal reformatted CT image after vertebroplasty shows sufficient cement filling in T12 vertebral body (arrow). No evidence of cement leakage is noted.

 

Figure 5
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  		Fig. 3 —Diagram illustrates areas used to measure vertebral body height in midsagittal plane. Wedge angle was measured in angle in lines along with superior and inferior endplates. (A=anterior, C=central, P=posterior.)

 

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