Noboru Tanigawa MD,PHD, Presenter: Nothing to Disclose

Atsushi Komemushi MD, PhD, Abstract Co-Author: Nothing to Disclose

Shuji Kariya MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Kojima MD, Abstract Co-Author: Nothing to Disclose

Yuzo Shomura MD, Abstract Co-Author: Nothing to Disclose

Satoshi Sawada MD, Abstract Co-Author: Nothing to Disclose

To prospectively investigate the relationship between cement distribution pattern and occurrence rate of new compression fractures following percutaneous vertebroplasty (PVP).

PVP was performed for osteoporotic compression fractures in 76 consecutive patients (mean age, 73.4 years, range 44-85 years 69 women and 7 men; 62 thoracic and 101 lumbar vertebrae). The 163 vertebral fractures were classified into cleft pattern(C-pattern) and trabecular pattern(T-pattern) according to the filling pattern of the cement on radiography and CT. Namely, compact and solid cement filling patterns in the vertebrae were classified as C-pattern, and the more sponge-like filling patterns were classified as T-pattern. Furthermore, patients with vertebrae that exhibited C-pattern were classified as C-pattern patients, and those without such vertebrae were classified as T pattern patients. A visual analog scale (VAS; 0-10) was used to assess pain severity, and anterior and lateral radiography of the thoracic and lumbar vertebrae were taken 1 day and 1, 4, 10 and 22 months after PVP. By using Mann-Whitney’s U test and chi-square test, groups were examined for differences in treatment efficacy and occurrence rate of new compression fractures.

Thirty four patients assigned to C-pattern patients, 42 to T-pattern patients. VAS scores in the C-pattern and T-pattern patients improved from 7.4±2.6 and 6.9±2.1 to 2.6±2.3 and 2.3±2.4 respectively 1-3 days after PVP, showing no statistically significant differences between the two groups(p=0.5). The mean follow-up period was 19.5 months, during which new compression fractures were revealed significantly more frequently in C-pattern patients than in T-pattern patients (17 of 34 (50%) vs. 11 of 42 (26.2%)) (p=0.009).

While cement distribution pattern did not significantly affect initial clinical response, there was a higher incidence of new compression fractures in patients exhibiting the cleft pattern of the injected cement.

While cement distribution pattern did not significantly affect initial clinical response, there was a higher incidence of new compression fractures in patients exhibiting cleft pattern of the cement.

Tanigawa, N, Komemushi, A, Kariya, S, Kojima, H, Shomura, Y, Sawada, S, Percutaneous Vertebroplasty: Relationship between Cement Distribution Pattern and New Compression Fracture following PVP.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433269.html