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Study Design:Retrospective analysis. Level of evidence III.Objectives:Low-energy vertebral compression fractures are an increasing socioeconomic problem among elderly patients. Percutaneous vertebroplasty has been extensively used for the treatment of painful fractures because of its effectiveness. However, some complications have been described; among them, new vertebral compression fractures, whether adjacent or not to the treated vertebra, are commonly reported complications (8% to 52%).Methods:We retrospectively analyzed epidemiological and technical variables presumably associated with new vertebral compression fractures. To determine the relationship between new vertebral compression fracture and percutaneous vertebroplasty, 30 patients (study group) with this complication were compared with 60 patients treated with percutaneous vertebroplasty without this condition (control group).Results:A higher cement percentage was found in the study group (40.3%) compared with the control group (30.5%). Initial vertebral kyphosis was significantly higher in the first group (15°) compared with the control group (9°). Epidemiological factors were similar in both groups.Conclusions:In our study, increased cement percentage injected and a higher kyphosis were associated with new vertebral compression fractures.

Synovial cysts at the atlantoaxial level are found uncommonly. Lumbar symptomatic cases are treated by percutaneous cyst aspiration with or without corticoid injection or by surgical resection, but synovial cysts at the C1-C2 level are usually treated by surgery. We report here a 92-year-old woman with a retro-odontoid synovial cyst producing spinal cord compression that was treated by percutaneous aspiration of the cyst under CT guidance. To our knowledge, this is the first reported case of an atlantoaxial synovial cyst successfully treated with a minimally invasive procedure.

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Objective: Percutaneous needle biopsy is an effective and safe technique for obtaining diagnostic material from bone lesions. Study Design: We describe the technical details of fine needle aspiration and core needle biopsy performed in our laboratory of orthopedic pathology. Results: With these procedures, we obtained accurate diagnosis in 83% of 7,375 cases, sent by different orthopedic centers in our country, over a period of 21 years (1986–2007). Conclusion: We describe the percutaneous needle procedure (fine needle aspiration, core needle biopsy), the handling of the materials in detail, the different cytological techniques, as well as the advantages of the procedures and how to avoid its disadvantages. We believe that accurate diagnosis with bone needle biopsy mainly depends on the training of the surgical cytologist and the pathologist, who must integrate all the knowledge on the clinical data, image diagnosis, histological procedures and the experience in the histopathological interpretation of bone lesions.

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The Mercedes-Benz Sign can be observed both on plain abdominal radiography and abdominal computed tomography as well. This radiological sign is formed by the presence of gas within gallstones, with a typical triradiate arrangement, and it may be indicative of biliary calculi. It was first seen in 1931 on plain radiographs performed on patients with unexplained abdominal pain and it was subsequently observed on computed tomography scans, an imaging procedure being increasingly used as the method of choice for the study of patients with abdominal complaints. Although the Mercedes-Benz sign is suggestive of gallstones in most cases, differential diagnoses such as emphysematous cholecystitis and gas in the biliary tract have to be performed.

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