STUDY DESIGN: A retrospective study to detect patients with cement leakage into the disc space following vertebroplasty. OBJECTIVE: To determine the frequency, causes, and clinical significance of cement leakage into the disc space. SUMMARY OF BACKGROUND DATA: Much has been written about cement leakage into the epidural space following vertebroplasty but only little about intradiscal leakage. METHODS: A total of 66 patients with 1 cemented osteoporotic, fractured vertebra between T5 and L5 were followed for at least 2 years. Two of the senior authors (Y.M. and A.P.) evaluated independently cement leakage into the disc space, possible causes were investigated, and the clinical results were evaluated according to patient self-assessment. RESULTS: Detected in 27 patients, cement leakage into the disc space did not negatively affect patient satisfaction with the procedure. In 7 of these patients, leakage occurred through an intravertebral vacuum cleft and, in 8, through a perforation of the endplate created by the needle tip. In only 2 patients was cement found to cross the height of the vertebral body and leak into the contralateral disc. CONCLUSIONS: Apart from iatrogenic endplate perforation, cement extravasation into the disc space was always found to occur through the fractured endplate or a vacuum cleft. Placing the needle tip far from the fractured endplate and using more solid cement appear to decrease the risk of leakage.
STUDY DESIGN: A retrospective study to detect patients with cement leakage into the disc space following vertebroplasty. OBJECTIVE: To determine the frequency, causes, and clinical significance of cement leakage into the disc space. SUMMARY OF BACKGROUND DATA: Much has been written about cement leakage into the epidural space following vertebroplasty but only little about intradiscal leakage. METHODS: A total of 66 patients with 1 cemented osteoporotic, fractured vertebra between T5 and L5 were followed for at least 2 years. Two of the senior authors (Y.M. and A.P.) evaluated independently cement leakage into the disc space, possible causes were investigated, and the clinical results were evaluated according to patient self-assessment. RESULTS: Detected in 27 patients, cement leakage into the disc space did not negatively affect patient satisfaction with the procedure. In 7 of these patients, leakage occurred through an intravertebral vacuum cleft and, in 8, through a perforation of the endplate created by the needle tip. In only 2 patients was cement found to cross the height of the vertebral body and leak into the contralateral disc. CONCLUSIONS: Apart from iatrogenic endplate perforation, cement extravasation into the disc space was always found to occur through the fractured endplate or a vacuum cleft. Placing the needle tip far from the fractured endplate and using more solid cement appear to decrease the risk of leakage.
Authors: L Fenoglio; P Cena; E Migliore; C Bracco; D Ferrigno; A Silvestri; G Lingua; G Gollè; C Brignone; C Serraino; G Gallarato; F Pomero; M Grosso Journal: J Endocrinol Invest Date: 2008-09 Impact factor: 4.256
Authors: Flavio Tancioni; Martin Lorenzetti; Pierina Navarria; Andrea Nozza; Luca Castagna; Paolo Gaetani; Enrico Aimar; Daniel Levi; Antonio Di Ieva; Patrizia Pisano; Armando Santoro; Marta Scorsetti; Riccardo Rodriguez y Baena Journal: Neurol Sci Date: 2010-04 Impact factor: 3.307