Prediction of Bone Cement Leakage in Patients Receiving Vertebroplasty by MRI Finding

Kim, Chang Su; Kim, Tae Kyun; Chae, Soo Uk; Yi, Young

Abstract

OBJECTIVES
To identify MRI predictors of bone cement leakage, we compared pre operative MRI and postoperative CT.
MATERIALS AND METHODS
Between October 2004 to March 2009, percuataneous vertebroplasties were performed in 58 patients from 167 patients of spine compression fracture. Among them, 37 patients took MRI before vertebroplasty and CT after operation to figure bone cement leakage. In 37 patients, 45 vertebras (T9; 1, T10; 3, T11; 5, T12; 8, L1; 11, L2; 9, L3; 4, L4; 3, L5; 1) preoperative MRI was taken to measure the presence of cortical disruption of the vertebral body and vacuum or cystic portion, severity of body compression, bone cement amount and bone cement amount/ severity of body compression ratio.
RESULTS
In postoperative CT scan of 42 vertebrae with bone cement, leakage was detected in 17 vertebrae (37.7%). However, no patients displayed any neurological symptoms or required surgery. Endplate cortical disruption was related to an increase risk of intervertebral bone cement leakage (P<0.05). Bone cement leakage tended to occur less frequently when there is a vacuum or fluid collection (P<0.05). No other factors showed significant relation with cement leakage.
CONCLUSIONS
Vertebroplasty group in magnetic resonance imaging of cortical damage to the vertebral endplates and fluid collection or vacuum changes when that can be useful to predict the leakage of bone cement after vertebroplasty group findings suggest.