Intracorporal bone grafting for vertebral compression fractures with intraosseous vacuum phenomenon

Chen, Lih Huei; Lai, Po Liang; Niu, Chi Chien; Chen, Chih-Hwa; Chen, Wen Jer; Fu, Tsai Sheng

doi:10.1007/s00264-003-0504-3

Cited by 9 publications

(13 citation statements)

References 19 publications

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“…Bhalla and Reinus [ 51 ] found that linear morphology of vacuum clefts are mostly associated with a benign process and are indicative of ischemic necrosis of the vertebral body. Several synonyms have been used in the literature to describe this feature: “linear intravertebral vacuum” [ 51 ], “intravertebral cleft” [ 52 ], “intravertebral vacuum phenomenon” [ 53 ], “intravertebral vacuum sign” [ 41 ], “Kü mmell sign” [ 25 ], and “intraosseous vacuum phenomenon” [ 54 ]. This sign is more easily detected on CT and appears more heterogeneous and irregular than that on X-ray radiographs [ 5 , 29 , 31 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

“…This MRI finding is referred as the fluid sign. The fluid collection appears as a well-defined area of low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and no enhancement on enhanced T1-weighted images [ 5 , 15 , 24 , 31 , 32 , 44 , 54 , 62 - 69 ]. Another MRI finding that is considered highly indicative of AVN is the so-called “double-line sign” (a central zone of hyperintensity surrounded by a hypointense band on T2-weighted images) [ 11 , 29 , 31 , 32 , 70 , 71 ], which has also been described in cases of AVN of the femoral head.…”

Section: Discussionmentioning

confidence: 99%

“…Augmentation methods to enhance pedicle screw fixation have improved, including instrumentation at multiple levels, bioactive cement augmentation, use of fenestrated or expandable pedicle screws [ 20 ], and sublaminar clamps and hooks to improve the stability of fusion. Posterior transpedicular vertebral bone grafting with pedicle screw fixation is another treatment option reported in the literature, although with contrasting results [ 39 , 54 , 97 , 98 ]. In most cases, prompt diagnosis of vertebral fracture can help prevent VBON, fix the deformity, and preclude the need for radical correction methods [ 30 , 99 , 100 ].…”

Section: Discussionmentioning

confidence: 99%

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What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

et al. 2018

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Osteonecrosis (ON) is a clinical entity characterized by a pattern of cell death and complex process of bone resorption and formation. Studies related to ON have largely focused on certain anatomical sites; however, the evidence on vertebral body ON (VBON) is largely inconsistent and fragmented. The aim of this study was to clarify the pathophysiology, risk factors, imaging findings, and available treatment modalities for VBON. A systematic review of the relevant articles published in English was performed using PubMed, Embase, Medline, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL databases. A total of 81 articles were included in this study. Three main topics about VBON were identified: (1) pathophysiology and risk factors, (2) diagnosis, and (3) treatment. Forty-five studies were based on the pathophysiology, 52 on diagnosis, and 38 on the treatment options for VBON. The literature on VBON was limited and mainly focused on post-traumatic cases with a considerable overlap with nonunion and pseudoarthrosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

et al. 2018

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“…17,18 There had been several surgical methods that had been described to improve the symptoms of patient with Journal of Orthopaedic Surgery 26 (3) osteoporotic vertebral fractures with intravertebral clefts such as percutaneous vertebroplasty, [17][18][19][20][21][22] balloon kyphoplasty 23,24 intracorporeal bone grafting. 25 These procedures were found to be suitable as they are minimally invasive and effective in providing pain relief and adequate stabilization. 18 Cement leakages were found to be less in fractures with intravertebral clefts when compared with those without clefts.…”

Section: Discussionmentioning

confidence: 99%

Do the dynamic stress mobility radiographs predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty for osteoporotic thoracolumbar vertebral fractures with intravertebral cleft?

Chiu

Lisitha²,

Elias

et al. 2018

J Orthop Surg (Hong Kong)

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Background: This prospective clinical-radiological study was conducted to determine whether the dynamic mobility stress radiographs can predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty. Methods: Patients included had the diagnosis of significant back pain caused by osteoporotic vertebral compression fracture secondary to trivial injury. All the patients underwent routine preoperative sitting lateral spine radiograph, supine stress lateral spine radiograph, and supine anteroposterior spine radiograph. The radiological parameters recorded were anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), MVH level below, wedge endplate angle (WEPA), and regional kyphotic angle (RKA). The supine stress versus sitting difference (SSD) for all the above parameters were calculated. Results: A total of 28 patients (4 males; 24 females) with the mean age of 75.6 + 7.7 years were recruited into this study. The mean cement volume injected was 5.5 + 1.8 ml. There was no difference between supine stress and postoperative radiographs for AVH (p ¼ 0.507), PVH (p ¼ 0.913) and WEPA (p ¼ 0.379). The MVH (p ¼ 0.026) and RKA (p ¼ 0.005) were significantly less in the supine stress radiographs compared to postoperative radiographs. There was significant correlation (p < 0.05) between supine stress and postoperative AVH, MVH, PVH, WEPA, and RKA. The SSD for AVH, PVH, WEPA, and RKA did not have significant correlation with the cement volume (p > 0.05). Only the SSD-MVH had significant correlation with cement volume, but the correlation was weak (r ¼ 0.39, p ¼ 0.04). Conclusions: Dynamic mobility stress radiographs can predict the postoperative vertebral height restoration and kyphosis correction after vertebroplasty for thoracolumbar osteoporotic fracture with intravertebral clefts. However, it did not reliably predict the amount of cement volume injected as it was affected by other factors.

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“…On radiograph, it appears as a transverse, linear or semi-lunar radiolucent shadow. There were many different synonyms for this sign: such as "intravertebral cleft" [5], "linear intravertebral vacuum" [12], "intravertebral vacuum phenomenon" [13], "intravertebral vacuum sign" [14], "intraosseous vacuum phenomenon" [15], "intra-vertebral pseudarthrosis" [7] or "Kümmell disease" [16]. …”

Section: Introductionmentioning

confidence: 99%

Vertebral Compression Fracture with Intravertebral Vacuum Cleft Sign: Pathogenesis, Image, and Surgical Intervention

Chi

2013

Asian Spine J

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The intravertebral vacuum cleft (IVC) sign in vertebral compression fracture patients has obtained much attention. The pathogenesis, image character and efficacy of surgical intervention were disputed. Many pathogenesis theories were proposed, and its image characters are distinct from malignancy and infection. Percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) have been the main therapeutic methods for these patients in recent years. Avascular necrosis theory is the most supported; PVP could relieve back pain, restore vertebral body height and correct the kyphotic angulation (KA), and is recommended for these patients. PKP seems to be more effective for the correction of KA and lower cement leakage. The Kümmell's disease with IVC sign reported by modern authors was incomplete consistent with syndrome reported by Dr. Hermann Kümmell.

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Intracorporal bone grafting for vertebral compression fractures with intraosseous vacuum phenomenon

Cited by 9 publications

References 19 publications

What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

Do the dynamic stress mobility radiographs predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty for osteoporotic thoracolumbar vertebral fractures with intravertebral cleft?

Vertebral Compression Fracture with Intravertebral Vacuum Cleft Sign: Pathogenesis, Image, and Surgical Intervention

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