Patient selection: osteoporotic compression fracture with indications for vertebroplasty
Cement leakage is associated with vertebral body fracture in the adjacent vertebra. It may also exert mechanical forces on the intervertebral disk.
Risk factors for cement leakage associated with preoperative MRI imaging:
(1) cortical defect at the compression fracture
(2) abnormal hyperintense T2 signal in the adjacent intervertebral disk space
(3) absence of an intravertebral cleft
where:
• A compression that is more comminuted is more likely to leak cement.
• A cortical defect is a discontinuity of cortical hypointensity on sagittal T2-weighted or fat-suppresed, contrast-enhanced T1-weighted images.
• An adjacent disk space that had a signal on T2-weight images higher than that seen in normal-appearing disk spaces was considered hyperintense.
• An intravertebral cleft was an abnormal T2 hyperintensity similar to cerebrospinal fluid (CSF).
• An intravertebral cleft may indicate fracture nonunion.
