Image Findings Following Vertebroplasty in Osteoporotic Vertebral Compression Fractures: Bone Healing and Sagittal Alignment

Hirotaka Ikeda, Misako Nishio, Shin Matsuoka, Brandon D. Lohman, Shoichiro Matsushita, Yukihisa Ogawa, Shingo Hamaguchi, Yasuo Nakajima, Atsushi Kojima, Yoshiaki Torii, Yutaka Sasao

Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan.

DOI: 10.4236/ojrad.2013.33025                

Abstract

Purpose: To clarify the effect of percutaneous vertebroplasty for vertebral compression fracture by assessing the changes of radiographic and CT image findings. Materials and Methods: A retrospective radiological analysis comprising 101 vertebrae of 48 patients who underwent percutaneous vertebroplasty for painful osteoporotic vertebral compression fracture was conducted. Whole spine radiographs and CT images were compared in patients preoperatively and 6 months postoperativey. Sagittal Cobb angles in three regions, sagittal vertical axis, and pelvic tilt were measured using whole spine lateral radiographs. CT findings due to the vertebral compression fracture, its healing process, and complications were evaluated. Results: On radiographs, sagittal alignment had an average gain of no more than 2.5° in each region. Sagittal vertical axis and pelvic tilt did not show significant change. Out of 68 vertebrae that demonstrated cortical disruption on preoperative CT, 37 (54%) demonstrated fusion of disrupted cortex on postoperative CT. Conclusion: No significant difference was observed between preoperative and postoperative spinal sagittal alignment on radiographs. However, CT did reveal healing process through fusion of disrupted cortex, intervertebral bridging, and increased density of cancellous bone. It is suggested that cement in the space of fracture may play a role in both mechanical stability and bone union.

Keywords

Vertebroplasty; Polymethylmetacrylate; CT; Sagittal Alignment; Bone Union

Conflicts of Interest

The authors declare no conflicts of interest.

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