Does segmental artery occlusion cause intravertebral cleft following osteoporotic vertebral fracture: a prospective magnetic resonance angiography study

Tianyu Zhang,Peixun Zhang,Yanhua Wang,Feng Xue,Yu Kang,Dianying Zhang

doi:10.1186/s12891-022-05064-8

Abstract

BackgroundThe avascular necrosis (AVN) hypothesis of intravertebral cleft (IVC) formation in osteoporotic vertebral fracture (OVCF) has received increasing attention. The aim of this article is to detect whether the segmental artery occlusion causes the IVC following OVCF.MethodsBetween December 2019 and April 2020, 44 OVCF patients with 46 fracture levels were prospectively enrolled and the vertebral segmental arteries were evaluated by magnetic resonance angiography (MRA). The artery conditions were divided into patent, narrow and occluded. The lesion segmental occlusion rate (LSOR) and the total occlusion rate (TOR) were calculated. The association of segmental artery occlusion and IVC formation was assessed.ResultsLOSR was 15.34% and TOR was 15.12%. The segmental arteries of the unfractured vertebrae had a higher occlusion rate at thoracolumbar levels than at non-thoracolumbar levels. There was no significant difference between the IVC group and the non-IVC group in the fractured levels artery occlusion rate (20.24 ± 28.08 vs 9.78 ± 19.56, P = 0.156) or the total segmental arteries occlusion rate (13.83 ± 12.04 vs 11.57 ± 9.25, P = 0.476).ConclusionsIn patients with vertebral osteoporotic fracture, segmental artery occlusion is not associated with the development of intravertebral cleft.

Highlights

Osteoporosis vertebral compression fracture (OVCF) is the most common osteoporosis fracture
Conservative or minimally invasive treatment can always relieve pain, poor prognosis frequently occurs in OVCF patients combined with intravertebral cleft (IVC) [1, 2]
IVC is a sign of osteonecrosis caused by the destruction of blood supply [11, 12]

Summary

Introduction

Osteoporosis vertebral compression fracture (OVCF) is the most common osteoporosis fracture. The AVN hypothesis received much attention among the above hypotheses. IVC is a sign of osteonecrosis caused by the destruction of blood supply [11, 12]. Kim et al [12] found a high artery occlusion rate in IVC patients by magnetic resonance angiography (MRA). Due to the lack of a control group in Kim’s study, segmental artery occlusion leading to the IVC could not be concluded. The aim of this study was to elucidate the association between segmental artery occlusion and IVC formation (Fig. 1e). The avascular necrosis (AVN) hypothesis of intravertebral cleft (IVC) formation in osteoporotic vertebral fracture (OVCF) has received increasing attention.

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