• Ai Min Wu, Zhong Ke Lin, Wen Fei Ni, Yong Long Chi, Hua Zi Xu, Xiang Yang Wang, and Qi Shan Huang.
• Department of Spinal Surgery, Second Affiliated Hospital of Wenzhou Medical College, Zhejiang Spine Research Center, Wenzhou, Zhejiang, People's Republic of China.
• J Spinal Disord Tech. 2014 May 1; 27 (3): E88-93.

Study DesignA retrospective comparative study.ObjectiveThe purpose of this study is to assess radiologic features of intravertebral cleft (IVC) in nonacute osteoporotic vertebral compression fractures (OVCFs) patients, and analyze the existence of IVC impact on outcomes of percutaneous kyphoplasty (PKP).Summary Of Background DataThe IVC sign is regarded as vertebral instability and the cause of persisting pain. It is more likely to happen at nonacute OVCFs patients. Patients with IVC sign have different outcomes from these without IVC treated by percutaneous vertebroplasty. There were rare reports about the outcomes of patients with IVC sign treated by PKP.Materials And MethodsWe divided 92 nonacute OVCFs patients (total of 113 vertebrae) into 2 groups according to the existence of IVC. Preoperative and postoperative Visual Analogue Scales, Oswestry Disability Index, kyphotic angulation (KA), and anterior vertebral height were recorded; the incidence and radiologic features of IVC were analyzed.ResultsThe diagnostic sensitivity of IVC on plain radiograph, computed tomography, and magnetic resonance imaging were 35.4%, 89.3%, and 83.3%, respectively. The IVC group had an average correction KA of 9.14 degrees and reduction of ratio of compression of 20.09%, and the non-IVC group was 8.76 degrees and 20.23%, respectively. Cleft pattern of cement accounted for 64.6% in IVC group and 27.7% in non-IVC group. Five/7 of cement leakage in IVC group was intradiscal leakage, whereas 7/9 of cement leakage in non-IVC group was perivertebral leakage.ConclusionsComputed tomography and magnetic resonance imaging were more sensitivity to diagnose IVC sign than X-ray. PKP could improve pain, functional activity, KA, and anterior height of both IVC and non-IVC groups, however, there was more cleft pattern of cement and higher intradiscal cement leakage in the IVC group.

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