Relationship Between Cement Distribution Pattern and New Compression Fracture After Percutaneous Vertebroplasty

Abstract

Although cement distribution patterns do not significantly affect initial clinical response, a higher incidence of new compression fractures is seen in patients with treated vertebrae exhibiting a cleft pattern.

Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty

“…Treatment of multiple vertebrae at initial presentation and compression fractures at the T-L junction may stimulate untreated vertebrae biomechanically, which was not proven in our study [7,9,11]. The distribution pattern of the cement may relate to cement amount and height restoration, and can affect the tension on the adjacent vertebrae [22]. This effect was not observed even though cement volume was significantly higher in compact type (P \ 0.01).…”

“…Cement distribution was classified as follows: (1) compact type-vertebrae with compact and solid filling, and (2) trabecular type-vertebrae with sponge-like filling [22] ( Fig. 2).…”

“…Several studies have reported an increase in the incidence of NVCF after bone cement augmentation, compared with conservative treatment [6,10,25]. The proposed risk factors include the amount of injected bone cement, intradiscal leakage, compact and solid cement pattern, and greater kyphosis correction [7,9,11,[13][14][15][20][21][22][23].…”

Magnetic Resonance Enhancement Pattern as a Predictor of Cement Volume in Vertebroplasty Procedures for Osteoporotic Fractures

“…To reduce the risk, many researchers have attempted to identify factors that affect the dosage or pattern of cement. For instance, Tanigawa et al (8) classified patterns of bone cement distribution based on post-procedure fluoroscopy for cleft patterns, compact and solid cement filling patterns in vertebrae, and trabecular or sponge-like filling patterns. They concluded that the volume of cement injected was greater for compact and solid cement filling patterns than for trabecular or sponge-like filling patterns, and the incidence of new compression fractures was higher for compact and solid cement filling pattern groups.…”

Perkutan Transpedikuler Vertebroplastide Kemik Cimento Kacagi: Yirmi Hastanin Analizi

“…Literatür incelendiğinde PVP işlemine bağlı enfeksiyon, epidural kanama, yağ embolisi, kardiak hasar gibi ciddi ek komplikasyonlar bildirilmiş olsada oldukça nadirdirler ve bizim klinik tecrubemizinde bu yönde olduğu izlenmiştir.Bunun yanında kullanılan kemik çimento akışkanlığı konusunda belirleyici bir ölçüm yönteminin bulunmayışı ile önerilen dişmacunu kıvamını elde etme konusunda gerekli koşulların sağlanması için standardın yerleşmemiş olması da etkileyici yöntemlerden biridir. Eğer yoğun kıvam elde edilirse işlemi yapmanın zorlaştığı ancak kaçak olasılığının azaldığı , yoğunluğun azalması ile birlikte kaçak riskinin arttığı da bilinmelidir (35)(36)(37). Optimum koşulları sağlamanın cerrahın deneyimi ile doğru orantılı olduğu düşünülmektedir.…”