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Vacuum Clefts of the Vertebral Bodies

Yigal Mirovskya,c, Yoram Aneksteina,c, Ehud Shalmona,c and Amir Peerb,c

a Spine Unit, Assaf Harofeh Medical Center, Zerifin, Israel
b Invasive Radiology Unit, Assaf Harofeh Medical Center, Zerifin, Israel
c Sacker Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel



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  		FIG 1. VC associated with an upper endplate fracture.



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  		FIG 2. VC associated with a fracture of the lower endplate.



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  		FIG 3. VC passing from the upper to the lower endplate.



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  		FIG 4. Serial lateral radiographs of a 69-year-old patient from group 2, with severe low back pain following forward bending.

A, Initial radiographs demonstrate mild collapse of the upper endplate.

B, One month later, a radiolucent line is seen below the fractured endplate.

C, Five weeks later, the radiolucent line has disappeared following further collapse of the endplate.



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  		FIG 5. Radiolucent line is visible, penetrating the degenerative disk above.



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  		FIG 6. Lateral radiographs of L3 following selective cementation of the cleft.



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  		FIG 7. Cement leakage to the upper disk via the cleft following cementation of the cleft.



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  		FIG 8. Pain score in both groups of patients.



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  		FIG 9. T1-weighted images of fractured vertebrae seen on MR image. On the left, a vertical VC demonstrated as a hypointense line is seen crossing the collapsed vertebra; on the right, no cleft is seen.



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  		FIG 10. CT reconstruction of a fracture in L2 following vertebroplasty. The cement was injected into the vertebral body and surrounds the sclerotic margins of the cleft without penetrating it.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X