Does Segmental Artery Occlusion Cause Intravertebral Cleft Following Osteoporotic Vertebral Fracture: a Prospective Magnetic Resonance Angiography Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2022 Feb 1

PMID 35101014

Authors

Tianyu Zhang

Yu Kang

Yanhua Wang

Peixun Zhang

Dianying Zhang

Feng Xue

Affiliations

Soon will be listed here.

Abstract

Background: The 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.

Methods: Between 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.

Results: LOSR 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).

Conclusions: In patients with vertebral osteoporotic fracture, segmental artery occlusion is not associated with the development of intravertebral cleft.

Citing Articles

The Associative Pattern Between Segmental Arterial Damage and Complete Neurological Disorder After Spinal Cord Injury: A Case-Control Study.

Boukebous B, Serfaty L, Hodges-Tai T, Baker J, Moyer J, Rousseau M Cureus. 2023; 15(3):e35918.

PMID: 36911583 PMC: 9996064. DOI: 10.7759/cureus.35918.

References

Heo D, Chin D, Yoon Y, Kuh S . Recollapse of previous vertebral compression fracture after percutaneous vertebroplasty. Osteoporos Int. 2008; 20(3):473-80. DOI: 10.1007/s00198-008-0682-3. View

Zhang T, Zhang P, Xue F, Zhang D, Jiang B . Risk factors for cement leakage and nomogram for predicting the intradiscal cement leakage after the vertebra augmented surgery. BMC Musculoskelet Disord. 2020; 21(1):792. PMC: 7702672. DOI: 10.1186/s12891-020-03810-4. View

Kim H, Kim S, Ju C, Kim S, Lee S, Shin H . The role of bone cement augmentation in the treatment of chronic symptomatic osteoporotic compression fracture. J Korean Neurosurg Soc. 2011; 48(6):490-5. PMC: 3053542. DOI: 10.3340/jkns.2010.48.6.490. View

Nambu K, Kawahara N, Kobayashi T, Murakami H, Ueda Y, Tomita K . Interruption of the bilateral segmental arteries at several levels: influence on vertebral blood flow. Spine (Phila Pa 1976). 2004; 29(14):1530-4. DOI: 10.1097/01.brs.0000131420.32770.06. View

Braunstein V, Sprecher C, Gisep A, Benneker L, Yen K, Schneider E . Long-term reaction to bone cement in osteoporotic bone: new bone formation in vertebral bodies after vertebroplasty. J Anat. 2008; 212(5):697-701. PMC: 2409083. DOI: 10.1111/j.1469-7580.2008.00883.x. View

Huang Y, Hao D, Feng H, Zhang H, He S, Ge C . Comparison of Percutaneous Kyphoplasty and Bone Cement-Augmented Short-Segment Pedicle Screw Fixation for Management of Kümmell Disease. Med Sci Monit. 2018; 24:1072-1079. PMC: 5829537. DOI: 10.12659/msm.905875. View

Lin W, Chen H, Lu C, Wang H, Wu R, Cheng Y . Dynamic contrast-enhanced magnetic resonance imaging for evaluating intraosseous cleft formation in patients with osteoporotic vertebral compression fractures before vertebroplasty. Spine (Phila Pa 1976). 2011; 36(15):1244-50. DOI: 10.1097/BRS.0b013e3181eb9b6c. View

He D, Yu W, Chen Z, Li L, Zhu K, Fan S . Pathogenesis of the intravertebral vacuum of Kümmell's disease. Exp Ther Med. 2016; 12(2):879-882. PMC: 4950591. DOI: 10.3892/etm.2016.3369. View

Libicher M, Appelt A, Berger I, Baier M, Meeder P, Grafe I . The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study. Eur Radiol. 2007; 17(9):2248-52. DOI: 10.1007/s00330-007-0684-0. View

10.

Formica M, Zanirato A, Cavagnaro L, Basso M, Divano S, Formica C . What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature. Asian Spine J. 2018; 12(3):586-599. PMC: 6002160. DOI: 10.4184/asj.2018.12.3.586. View

11.

Tezuka F, Sakai T, Nishisho T, Takata Y, Higashino K, Takao S . Variations in arterial supply to the lower lumbar spine. Eur Spine J. 2016; 25(12):4181-4187. DOI: 10.1007/s00586-016-4427-2. View

12.

Lu W, Wang L, Xie C, Teng Z, Han G, Shi R . Analysis of percutaneous kyphoplasty or short-segmental fixation combined with vertebroplasty in the treatment of Kummell disease. J Orthop Surg Res. 2019; 14(1):311. PMC: 6743117. DOI: 10.1186/s13018-019-1358-8. View

13.

Kurunlahti M, Karppinen J, Haapea M, Niinimaki J, Autio R, Vanharanta H . Three-year follow-up of lumbar artery occlusion with magnetic resonance angiography in patients with sciatica: associations between occlusion and patient-reported symptoms. Spine (Phila Pa 1976). 2004; 29(16):1804-8. DOI: 10.1097/01.brs.0000134576.77709.64. View

14.

Zhang T, Wang Y, Zhang P, Xue F, Zhang D, Jiang B . What Are the Risk Factors for Adjacent Vertebral Fracture After Vertebral Augmentation? A Meta-Analysis of Published Studies. Global Spine J. 2020; 12(1):130-141. PMC: 8965299. DOI: 10.1177/2192568220978223. View

15.

Armingeat T, Pham T, Legre V, Lafforgue P . Coexistence of intravertebral vacuum and intradiscal vacuum. Joint Bone Spine. 2006; 73(4):428-32. DOI: 10.1016/j.jbspin.2005.10.011. View

16.

Huang Y, Hao D, Wang X, Sun H, Du J, Yang J . Long-Segment or Bone Cement-Augmented Short-Segment Fixation for Kummell Disease with Neurologic Deficits? A Comparative Cohort Study. World Neurosurg. 2018; 116:e1079-e1086. DOI: 10.1016/j.wneu.2018.05.171. View

17.

Kim Y, Kim Y, Ha K . Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine. Spine J. 2013; 14(4):659-66. DOI: 10.1016/j.spinee.2013.06.106. View

18.

Kauppila L . Prevalence of stenotic changes in arteries supplying the lumbar spine. A postmortem angiographic study on 140 subjects. Ann Rheum Dis. 1997; 56(10):591-5. PMC: 1752265. DOI: 10.1136/ard.56.10.591. View

19.

Yu W, Liang D, Yao Z, Qiu T, Ye L, Huang X . Risk factors for recollapse of the augmented vertebrae after percutaneous vertebroplasty for osteoporotic vertebral fractures with intravertebral vacuum cleft. Medicine (Baltimore). 2017; 96(2):e5675. PMC: 5266161. DOI: 10.1097/MD.0000000000005675. View

20.

Dupuy D, Palmer W, Rosenthal D . Vertebral fluid collection associated with vertebral collapse. AJR Am J Roentgenol. 1996; 167(6):1535-8. DOI: 10.2214/ajr.167.6.8956592. View