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Vertebral Endplate Fractures: An Indicator of the Abnormal Forces Generated in the Spine after Vertebroplasty.

Kennith Franklin LAYTON
Kennith Franklin LAYTON MD
Texas, Dallas
Radiology
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* Date : 06-08-2009 - 07:31 PM (5407 days ago),

* Characters : 2142, Words : 283, Size : 2.09 Kb.
Vertebral Endplate Fractures: An Indicator of the Abnormal Forces Generated in the Spine after Vertebroplasty.

Vertebroplasty alters spinal biomechanics and may lead to incident vertebral fractures. The endplate localization of prevalent and incident fractures was evaluated in 86 patients. In the absence of vertebroplasty, superior endplate fractures predominate. After the procedure, inferior endplate fractures are disproportionately common in adjacent vertebrae immediately above the treated level, potentially supporting a causative relationship between vertebroplasty and incident fractures. INTRODUCTION: To determine retrospectively whether new-onset fractures after vertebroplasty tend to cluster in the endplate immediately adjacent to the cemented vertebra. MATERIALS AND METHODS: Institutional Review Board approval and patient consent for use the use of medical records were obtained for this study. We performed a retrospective review of patients with new (incident) vertebral fractures after vertebroplasty. The median age for these patients was 72.5 years, and 58 (67.4%) were women. Fractures were diagnosed on the basis of MRI or bone scan and were catalogued based on their location within the vertebral body (superior endplate, inferior endplate, or holo-vertebral). Chi(2) and generalized estimating equation (GEE) analyses were used to compare the distribution of fracture subtypes among pre-existing (prevalent) and incident fractures. RESULTS: The patients had 313 prevalent osteoporotic vertebral fractures and were treated at 137 vertebral levels. Among prevalent fractures, superior endplate fractures predominated (57% superior, 11% inferior; p < 0.0001). After vertebroplasty, 186 incident fractures developed in these 86 patients. Seventy-seven (41%) of these incident fractures occurred adjacent to treated vertebrae. Nonadjacent, incident fractures, like prevalent fractures, occurred predominantly along superior endplate. Incident fractures immediately above treated levels, however, localized disproportionately to the inferior endplate (30% superior, 57% inferior; p < 0.0001). CONCLUSIONS: There are an increased number of inferior endplate fractures of the vertebral body immediately cephalad to the treated level.

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Other Articles by Kennith Franklin LAYTON MD:
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  • A Modified Vertebroplasty Approach For Spine Biopsies.
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  • Transarterial Coil Embolization Of The Venous Component Of Aggressive Type 4 Dural Arteriovenous Fistulas.
  • The Radial Artery Access Site For Interventional Neuroradiology Procedures.
  • Bovine Aortic Arch Variant İn Humans: Clarification Of A Common Misnomer.
  • Subsequent Vertebral Fractures After Vertebroplasty: Association With Intraosseous Clefts.
  • Acute Vertebral Compression Fractures İn Patients With Multiple Myeloma: Evaluation Of Vertebral Body Edema Patterns On Mr Imaging And The Implications For Vertebroplasty.
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  • Outcomes Of Patients Receiving Long-Term Corticosteroid Therapy Who Undergo Percutaneous Vertebroplasty.
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