Vertebral fluid collection associated with vertebral collapse.

Dupuy, Damian E.; Palmer, William E.; Rosenthal, D I

doi:10.2214/ajr.167.6.8956592

Cited by 71 publications

(40 citation statements)

References 4 publications

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“…In the present study, we found that IVC (10 recompressions out of 24 IVCs) was one of the factors most strongly related to recompression. IVC provides radiological evidence of osteonecrosis [5,19,22,24,27], or nonunion and pseudoarthrosis after vertebral fracture [1,2,11,13,23]. Whatever the reasons, IVC might be made in chronic period of fracture healing process after initial trauma.…”

Section: Discussionmentioning

confidence: 99%

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

2010

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The purpose of this retrospective clinical study was to evaluate the factors that affect recompression of operated vertebrae after percutaneous balloon kyphoplasty (PKP) for osteoporotic vertebral compression fractures (VCFs) and assess their clinical importance. PKP has been used for VCFs with satisfactory results. Several studies about subsequent VCFs adjacent to cemented vertebrae have been reported after PKP. However, the presence and significance of recompression of operated vertebrae have not been adequately described. In total, 80 patients treated with PKP for single thoracolumbar VCFs were reviewed. The follow-up period was at least 1 year. Patients were divided into those without recompression (maintained group, n = 70) and those with recompression (recompressed group, n = 10). Plain roentgenography (preoperative, operative, and last), preoperative BMD, and preoperative MRI were checked. Age, gender, T-score in BMD, duration of symptom, compression rate (CR) of VCF, reduction rate, kyphotic angle (KA), reduction angle, intervertebral cleft (IVC), and non-PMMA-endplate-contact (NPEC) were evaluated. To evaluate the clinical results, we checked the VAS score at each follow-up period. All data were analyzed statistically. The CR for the recompressed group increased significantly after surgery and decreased at the last follow-up (p \ 0.05). The last CR was not significantly different from the preoperative CR. The KA showed the same pattern. The preoperative, postoperative, and last VAS scores were significantly different from one another in both groups (p \ 0.05). Between the groups, preoperative KA, postoperative KA, last KA, IVC, and NPEC were significantly different (p \ 0.05). In particular, last KA, IVC, and NPEC showed highly significant differences (p \ 0.001). In a correlation test for the evaluated factors, IVC (r = 0.557) and NPEC (r = 0.496) were the most significant. The presence of IVC and NPEC may play an important role in inducing recompression of treated vertebrae after PKP. Careful observation of patients with these conditions is necessary to prevent deterioration of their clinical course.

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Section: Discussionmentioning

confidence: 99%

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

2010

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“…Controversies exist regarding the pathomechanism of the fluid sign and intravertebral vacuum cleft in the osteoporotic spinal fracture. Some authors have proposed that osteoporotic fracture leads to interruption of the blood supply to the vertebral body and fluid accumulation in the ON space [14,27]. If nonunion occurred and resulted in excessive motion, the central portion of the callus might undergo cystic degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…The MRI protocol included sagittal and axial T1-weighted fast spin-echo images, axial T2-weighted fast spin-echo images, and sagittal short inversion time inversion-recovery (STIR) images with 4-mm section thickness. The vertebral compression fractures might contain an accumulation of intravertebral fluid described as a well-circumscribed area of low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted images (isointense to cerebrospinal fluid), which belongs to the fluid sign [14,16]. The vacuum phenomenon is a collection of gas which creates a linear or semi-lunar radiolucent shadow on the radiograph [15,17].…”

Section: Radiological Evaluationmentioning

confidence: 99%

“…With the advent of radiograph technology, the researches of modern imaging have offered a great contribution to the clinical diagnosis, decision of treatment and prognosis of spinal disorders [11][12][13]. In the literatures, posttraumatic vertebral ON was diagnosed based on the radiological findings of a fluid sign or intravertebral vacuum phenomenon [14][15][16][17]. Nevertheless, the correlation between the radiological and histopathologic findings has seldom been reported, especially by means of an open retrieval of specimens.…”

Section: Introductionmentioning

confidence: 99%

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MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

Lin

Huang

et al. 2012

Eur Spine J

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Introduction Magnetic resonance images (MRI) fluid sign and intravertebral vacuum phenomenon of the plain radiograph are considered as the characteristic radiological findings for vertebral osteonecrosis after spinal fractures. We aim to study the association between the radiological and histopathologic findings of vertebral osteonecrosis through the use of an open retrieval of specimens. Materials and methods Twenty consecutive patients (54-84 years, mean 73 years) of unstable vertebral compression fractures treated with anterior corpectomy and fusion were included. All the images and pathologies were correlated, especially the histopathologic changes to the fluid sign and vacuum phenomenon.Results MRI fluid signs and the histopathologic findings of vertebral osteonecrosis were significantly correlated and both were noted in the first 5 months after injury. The power of the fluid sign in diagnosing vertebral osteonecrosis was better than that of the intravertebral vacuum phenomenon (diagnostic odds ratio 65 vs. 2, sensitivity 86 vs. 50 %, specificity 100 vs. 67 %). Conclusion MRI fluid sign is more predictable to diagnose vertebral osteonecrosis in operative case, especially within the initial 5 months after injury.

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“…Many authors reported Kummell disease as vertebral cleft, fluid sign or intravertebral vacuum 1,7,8,16,20) . Although KE could be considered to have a similar enhancement pattern to EBS, KE reveals a sharply marginated enhancement around the vacuum cleft or fluid because the unhealed fracture or fluid has no adjacent inflammatory change and is distinctly divided from the enhancing wall 7,20) .…”

Section: Discussionmentioning

confidence: 99%

Enhancing Box Sign : Enhancement Pattern of Acute Osteoprotic Compression Fracture

Kim

Park

Chung

et al. 2009

J Korean Neurosurg Soc

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Objective : Although gadolinium enhancement of compression fractures is well known, the enhancement pattern of the acute stage of a fracture is not completely understood. Here, we investigated the enhancement pattern of acute vertebral compression fractures (VCFs). Methods : We conducted a retrospective study of patients with acute osteoporotic VCFs admitted to hospital between January 2004 and December 2005. The demographic details, stage of the fracture, management data, and results were analyzed. There were nine men and 22 women, and the mean age was 71 years (range, 53-92 years). According to the onset of pain, patients were divided into the following four groups : Group I (less than 3 days), Group II (4-7 days), Group III (8-14 days), and Group IV (14-30 days). Results : All patients had central low-signal intensity of the nonenhancing part of vertebral bodies on T1 images. Enhancing box sign (EBS) was seen 7 days of VCF development. After 7 days of onset (Groups III and IV), patch or Kummell's enhancements occurred. EBS has been statistically correlated with stage of compression fracture (Pearson's correlation = -0.774). However, EBS had no statistically significant correlation with prognosis in our study (Pearson's correlation = 0.059). Conclusion : EBS represents a characteristic sign 7 days of VCF development.

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Vertebral fluid collection associated with vertebral collapse.

Cited by 71 publications

References 4 publications

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

Enhancing Box Sign : Enhancement Pattern of Acute Osteoprotic Compression Fracture

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