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Updated: Jun 19, 2026
Nine-Grid Area Division Method: A New Ideal Bone Puncture Region for Percutaneous Vertebroplasty in Lumbar Spine
Published on: August 9, 2024
Cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with or without intravertebral
Noboru Tanigawa1, Shuji Kariya, Atsushi Komemushi
1Department of Radiology, Kansai Medical University, Hirakata Hospital, Hirakata, Osaka 573-1191, Japan. tanigano@hirakata.kmu.ac.jp
Objective:
The purpose of our study was to compare the incidence and location of cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with and without intravertebral clefts.
Materials And Methods:
Percutaneous vertebroplasty was performed in 120 consecutive patients with 300 osteoporotic compression fractures. The cement volume injected was recorded. The cement leakage was evaluated using spinal radiography, MRI, and fluoroscopy during the procedure and CT after the procedure.
Results:
One hundred seven vertebrae contained intervertebral clefts, and 193 vertebrae had no clefts. The cement volume injected (+/- SD) was 4.0 +/- 2.0 and 3.6 +/- 1.6 mL into vertebrae with clefts and without clefts, respectively, with no statistically significant difference (p = 0.14). There was no statistically significant difference in the incidence of cement leakage between vertebrae with clefts (53 of 107) and those without clefts (78 of 193) (p = 0.13). Leakage occurred into the epidural veins (12 of 107), perivertebral soft tissues (7 of 107), disks (41 of 107), intervertebral foramen (1 of 107), and spinal canal (1 of 107) in fractures with clefts and into the epidural veins (47 of 193), perivertebral soft tissues (13 of 193), disks (25 of 193), paravertebral veins (5 of 193), large vein (2 of 193), lung (2 of 193), intervertebral foramen (1 of 193), and spinal canal (1 of 193) in fractures without clefts. Cement leakage into the epidural vein was significantly more frequent in vertebrae without clefts (p < 0.01). Disk leakage was significantly more frequent in vertebrae with clefts compared with those without clefts (p < 0.01).
Conclusion:
There was no statistically significant difference in the incidence of cement leakage between vertebrae with clefts and without clefts. However, cement leakage into the epidural vein was significantly more frequent in vertebrae without clefts and disk leakage was significantly more frequent in vertebrae with clefts.