Abstract
In some cases of vertebroplasty for adjacent fractures, we observed a cement bridging phenomenon, in which the injected cement flowed from the newly fractured vertebra to the previously cement-augmented vertebra through the space between the abutting anterior longitudinal ligament and the vertebral column. The purpose of this retrospective study was to investigate this phenomenon. From January 2012 to December 2014, patients who sustained new-onset adjacent vertebral compression fracture and who were again treated with vertebroplasty were enrolled. We divided the patients into two groups, the bridging group and the nonbridging group, to analyze the difference between them. Results showed that the cement bridging phenomenon occurred in 18 (22.8%) of the 79 patients. Significant differences between the bridging and nonbridging groups were identified in the following 3 imaging features: severe loss of the anterior vertebral body height at the new-onset adjacent vertebra on plain film (odds ratio [OR] = 4.46, p = 0.014), fluid accumulation (OR = 36.27, p < 0.001) and hypointense signaling (OR = 15.67, p < 0.001) around the space anterior to the abutting vertebral bodies and the corresponding intervertebral disc on MRI. After a 2-year follow-up, both the mean value of the focal kyphotic angle and anterior body height ratio were significantly better in the cement bridging group than in the nonbridging group. The cement bridging phenomenon, which has never been reported in the literature, is not rare in clinical practice. This phenomenon was associated with better maintenance of focal kyphotic angle and anterior body height ratio during the 2-year follow-up.
Highlights
In some cases of vertebroplasty for adjacent fractures, we observed a cement bridging phenomenon, in which the injected cement flowed from the newly fractured vertebra to the previously cementaugmented vertebra through the space between the abutting anterior longitudinal ligament and the vertebral column
The severe loss in the anterior vertebral body height at the new-onset adjacent vertebra on plain film, fluid accumulation and hypointense signaling around the space anterior to the abutting vertebral bodies and the corresponding intervertebral disc on MRI were the three predictors of the cement bridging phenomenon (CBP) identified in this study
The cement bridging phenomenon (CBP), which has never been reported in the literature, is not rare in clinical practice
Summary
In some cases of vertebroplasty for adjacent fractures, we observed a cement bridging phenomenon, in which the injected cement flowed from the newly fractured vertebra to the previously cementaugmented vertebra through the space between the abutting anterior longitudinal ligament and the vertebral column. During the procedure of percutaneous vertebroplasty for new-onset adjacent vertebral compression fracture, we observed a cement bridging phenomenon (CBP), in which the injected cement flowed from the newly fractured vertebra to the previously cement-augmented vertebra through the space between the abutting anterior longitudinal ligament and the vertebral column (Fig. 1). This phenomenon has never been described in the literature. The purpose of our study was to elucidate this phenomenon, and further analyze the imaging predictors and clinical significance of the cement bridging phenomenon
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