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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:1042-1045, June-July 2007
DOI 10.3174/ajnr.A0520
© 2007 American Society of Neuroradiology

SPINE

New Symptomatic Compression Fracture after Percutaneous Vertebroplasty at the Thoracolumbar Junction

C.C. Lin^a, I.H. Chen^b, T.C. Yu^b, A. Chen^a,c and P.S. Yen^a

^a Departments of Medical Imaging, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
^b Orthopedics, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
^c Anesthesiology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan

Address correspondence to Dr. Pao-Sheng Yen, Department of Radiology, Buddhist Tzu Chi General Hospital, Tzu Chi University, 707, Section 3, Chung Yang Road, Hualien, Taiwan; e-mail:cc{at}tma.tw

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the risk factors for new symptomatic vertebral compression fractures after vertebroplasty at the thoracolumbar junction.

MATERIALS AND METHODS: We conducted a retrospective analysis of 53 patients treated with percutaneous vertebroplasty at the thoracolumbar junction (T12, L1). The follow-up period was 15–27 months. The occurrence of new symptomatic vertebral compression fractures was recorded after vertebroplasty. We evaluated patient age and sex, amount of injected cement, vacuum clefts in the collapsed bodies, initial wedge angle of the compression fracture, change of the wedge angle after vertebroplasty, intradiskal cement leak, and percentage of height restoration of the vertebral body. In this report, we surveyed the possible risk factors for new symptomatic vertebral compression fractures.

RESULTS: Thirty-nine (74%) of the 53 patients had fluid and/or air in the compression fracture at the thoracolumbar junction (T12, L1). Eight (20.5%) of the 39 patients with vacuum clefts had new symptomatic compression fracture after vertebroplasty between 1 month and 4 days after surgery to 23 months and 4 days after surgery. The patients with new symptomatic compression fracture had higher initial wedge angle and wedge angle change (more than 7°) after vertebroplasty than those without fractures; these data were considered statistically significant.

CONCLUSIONS: The incidence of vacuum clefts in the compression fracture at the thoracolumbar junction is high (74%). The severity of initial wedge angle and wedge angle change affects the incidence of new symptomatic compression fracture.