Vertebroplasty: Cement Leakage into the Disc Increases the Risk of New Fracture of Adjacent Vertebral Body
Edward P. Lina,
Sven Ekholma,
Akio Hiwatashia and
Per-Lennart Westessona
a From the Department of Radiology, Division of Diagnostic & Interventional Neuroradiology, University of Rochester Medical Center, Rochester, NY
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FIG 1. Images of an 85-year-old woman with back pain.
A, Pre-vertebroplasty sagittal view T1-weighted MR image shows bone marrow edema of T12.
B, Pre-vertebroplasty sagittal view T2-weighted MR image shows bone marrow edema of T12.
C, Sagittal view contrast-enhanced T1-weighted MR image shows enhancement, indicating an acute T12 compression fracture.
D, Post-vertebroplasty sagittal view reformatted CT scan shows cement leakage into the T11–T12 disk.
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FIG. 1. Continued
E, Sagittal view T1-weighted MR image obtained 15 days later, when the patient returned with new pain, shows new bone marrow edema of T11.
F, Sagittal view T2-weighted MR image obtained 15 days later, when the patient returned with new pain, shows new bone marrow edema of T11.
G, Contrast-enhanced sagittal view T1-weighted MR image shows T11 enhancement, indicating a new acute T11 fracture.
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FIG 2. Images of a 79-year-old man with back pain.
A, Pre-vertebroplasty sagittal view T1-weighted MR image shows bone marrow edema of T12 and L1.
B, Pre-vertebroplasty sagittal view T2-weighted MR image shows bone marrow edema of T12 and L1.
C, Sagittal view contrast-enhanced T1-weighted MR image shows enhancement, indicating acute T12 and L1 compression fractures.
D, Post-vertebroplasty sagittal view reformatted CT scan shows cement leakage (arrow) into the L1–L2 disk. Of note, leakage of cement into the T11–T12 disk also occurred. However, T11 was treated with vertebroplasty at the same time as T12 and T11 therefore could not be evaluated for a possible new fracture.
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FIG 2. Continued
E, Sagittal view T1-weighted MR image obtained 25 days later, when the patient returned with new pain, shows a focal area of new bone marrow edema of L2 (arrows).
F, Sagittal view T2-weighted MR image obtained 25 days later, when the patient returned with new pain, shows a focal area of new bone marrow edema of L2 (arrows).
G, Contrast-enhanced sagittal view T1-weighted MR image shows enhancement, indicating a new acute focal fracture of L2 superiorly. The new fracture (arrows) is located immediately adjacent to the cement leakage into the disk.
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