The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study

Libicher, M.; Appelt, Andreas; Berger, Irina; Baier, Martin; Meeder, P. J.; Grafe, Ingo; DaFonseca, K.; Nöldge, G.; Kasperk, Christian

doi:10.1007/s00330-007-0684-0

Cited by 133 publications

(96 citation statements)

References 29 publications

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“…The most important risk factors for the development of an intravertebral gas cleft are osteoporotic vertebral fractures, steroid medication, trauma, and radiation therapy (11). Thus a vertebral compression fracture seems to represent the initial event (11).…”

Section: Discussionmentioning

confidence: 99%

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Coulier

2013

Journal of the Belgian Society of Radiology

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We report two very unusual observations in which gas and fluid effusions were transiently and unexpectedly found in the extravertebral spaces of patients presenting with painful necrotic vertebral collapse containing a vacuum cleft. We hypothesize that gas and/or fluid which progressively may replace vacuum in vertebral compression fractures could be secondarily pumped through extravertebral and retroperitoneal spaces. Although being rare, these observations may represent a potential missing link in the imaging snapshots of the cyclic and dynamic vacuum phenomenon.

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Section: Discussionmentioning

confidence: 99%

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Coulier

2013

Journal of the Belgian Society of Radiology

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“…In the present study, we found that IVC (10 recompressions out of 24 IVCs) was one of the factors most strongly related to recompression. IVC provides radiological evidence of osteonecrosis [5,19,22,24,27], or nonunion and pseudoarthrosis after vertebral fracture [1,2,11,13,23]. Whatever the reasons, IVC might be made in chronic period of fracture healing process after initial trauma.…”

Section: Discussionmentioning

confidence: 99%

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

2010

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The purpose of this retrospective clinical study was to evaluate the factors that affect recompression of operated vertebrae after percutaneous balloon kyphoplasty (PKP) for osteoporotic vertebral compression fractures (VCFs) and assess their clinical importance. PKP has been used for VCFs with satisfactory results. Several studies about subsequent VCFs adjacent to cemented vertebrae have been reported after PKP. However, the presence and significance of recompression of operated vertebrae have not been adequately described. In total, 80 patients treated with PKP for single thoracolumbar VCFs were reviewed. The follow-up period was at least 1 year. Patients were divided into those without recompression (maintained group, n = 70) and those with recompression (recompressed group, n = 10). Plain roentgenography (preoperative, operative, and last), preoperative BMD, and preoperative MRI were checked. Age, gender, T-score in BMD, duration of symptom, compression rate (CR) of VCF, reduction rate, kyphotic angle (KA), reduction angle, intervertebral cleft (IVC), and non-PMMA-endplate-contact (NPEC) were evaluated. To evaluate the clinical results, we checked the VAS score at each follow-up period. All data were analyzed statistically. The CR for the recompressed group increased significantly after surgery and decreased at the last follow-up (p \ 0.05). The last CR was not significantly different from the preoperative CR. The KA showed the same pattern. The preoperative, postoperative, and last VAS scores were significantly different from one another in both groups (p \ 0.05). Between the groups, preoperative KA, postoperative KA, last KA, IVC, and NPEC were significantly different (p \ 0.05). In particular, last KA, IVC, and NPEC showed highly significant differences (p \ 0.001). In a correlation test for the evaluated factors, IVC (r = 0.557) and NPEC (r = 0.496) were the most significant. The presence of IVC and NPEC may play an important role in inducing recompression of treated vertebrae after PKP. Careful observation of patients with these conditions is necessary to prevent deterioration of their clinical course.

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“…Thus, it is important to obtain the diagnosis of vertebral ON prior to making a decision on treatment, since it should be taken into consideration. Currently, vertebral ON remains a radiographic diagnosis, but most studies correlated the histopathology and image finding from percutaneous needle biopsy [4,25,26]. To the best of our knowledge, only Baur et al [27] reported the histological comparison of fluid sign in four osteoporotic and one metastatic fracture by open retrieval of specimen from surgery.…”

Section: Discussionmentioning

confidence: 99%

MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

Lin

Huang

et al. 2012

Eur Spine J

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Introduction Magnetic resonance images (MRI) fluid sign and intravertebral vacuum phenomenon of the plain radiograph are considered as the characteristic radiological findings for vertebral osteonecrosis after spinal fractures. We aim to study the association between the radiological and histopathologic findings of vertebral osteonecrosis through the use of an open retrieval of specimens. Materials and methods Twenty consecutive patients (54-84 years, mean 73 years) of unstable vertebral compression fractures treated with anterior corpectomy and fusion were included. All the images and pathologies were correlated, especially the histopathologic changes to the fluid sign and vacuum phenomenon.Results MRI fluid signs and the histopathologic findings of vertebral osteonecrosis were significantly correlated and both were noted in the first 5 months after injury. The power of the fluid sign in diagnosing vertebral osteonecrosis was better than that of the intravertebral vacuum phenomenon (diagnostic odds ratio 65 vs. 2, sensitivity 86 vs. 50 %, specificity 100 vs. 67 %). Conclusion MRI fluid sign is more predictable to diagnose vertebral osteonecrosis in operative case, especially within the initial 5 months after injury.

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The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study

Cited by 133 publications

References 29 publications

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Extravertebral gas and fluid effusions associated with vertebral collapse containing a vacuum cleft possibly result from a pumping phenomenon: a new evidence of the dynamic hydro-pneumatical nature of the so-called vacuum phenomenon

Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture

MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

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