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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 1, 83-89.
doi: 10.1302/0301-620X.85B1.13026  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures

J. S. Yeom, MD, Assistant Professor; W. J. Kim, MD, Associate Professor; and W. S. Choy, MD, Professor

Department of Orthopaedic Surgery, Eulji University Hospital, 24 Mok-dong, Chung-ku, Daejon 301-726, Korea.

C. K. Lee, MD, Professor; and B. S. Chang, MD, Assistant Professor

Department of Orthopaedic Surgery, College of Medicine, Seoul National University, 28 Yungun-Dong, Chongro-Ku, Seoul 110-744, Korea.

J. W. Kang, MD, Staff Surgeon

Department of Orthopaedic Surgery, Cheongju St Mary’s Hospital, 589-5 Jujung-dong, Sangdang-gu, Cheongju 360-568, Korea.

Correspondence should be sent to Dr J. S. Yeom.

We analysed the CT scans and radiographs of 76 vertebrae in 49 patients who underwent vertebroplasty for painful osteoporotic compression fractures. Leaks of cement were classified into three types: those via the basivertebral vein (type B), via the segmental vein (type S), and through a cortical defect (type C).

More leaks were identified on CT scans than on radiographs by a factor of 1.5 (74/49). Most type-B (93%) and type-S (86%) leaks were missed or underestimated on a lateral radiograph which is usually the only view used during the injection of cement. Of the leaks into the spinal canal, only 7% (2/28) were correctly identified on radiographs. The areas on lateral radiographs where this type of leak may be observed were divided into four zones, and their diagnostic value in predicting a leak into the spinal canal was evaluated. The results showed that cement in the neural foramina had the highest positive predictive value (86%).




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General