Vertebral Compression Fractures With Intravertebral Vacuum Sign: Pathogenesis, Diagnosis And Treatment

Objective: To explore the pathogenesis, clinical features, treatment principles and the results after percutaneous vertebroplasty(PVP) of vertebral compression fractures (VCFs) with intravertebral vacuum(IVV) sign.Methods: To retrospectively analyze 23 patients 25 cases of VCFs with IVV sign, summarize the pathogenesis, clinical and imaging fractures and treatment principles.To use the evaluation methods included visual analogue scale(Fig 1), anterior vertebral height(Fig 2), analyze and evaluate the results of PVP.Results: 1. In this group, the back pain history of the patients were an average of 4.8 months; the IVV sign was mainly concentrated in the T12 ,L1 vertebral bodies(Fig 3). 2. The IVV sign Performance by X-ray and CT showed an irregular shape of the gas density shadow, MRI showed hypointense signal on T1WI, hypointense or hypointense and hyperintense mixed signal on T2WI and STIR, the hypointense and hyperintense signal was separated by a clear and sharp Gas-liquid boundary. 3. There were 18 patients with 20 vertebral bodies treatmented with PVP, the pain score by VAS reduced from 8.3 to 1.9(Fig 4), there was a significant statistically difference(t = 21.922, P < 0.05), the anterior vertebral height increased from 13.4 mm to 18.9 mm, there was a significant statistically difference(t = 9.984, P <0.05), the compressed ratios of the anterior vertebral body reduced from 47% to 25%, there was a significant statistically difference(t = 10.467, P <0.05).Conclusion: Vertebral compression fractures is result of many factors,this disease often occurred in the thoracolumbar junction, The IVV sign is related to the nonunion of VCFs, is a special subtype of VCFs. X-ray can be used as a primary method to diagnose this disease; CT is the most direct and accurate diagnostic tools; MRI can be further defined the shape of the cavities and the distribution of gas and liquid; the diagnosis should be in accordance with medical history, clinical and imaging features.The treatment of this disease was based on" Early, Minimally invasive, Quickly and Steadiness" principles.PVP have favorable results, fewer complications, is a ideal treatment of this disease.