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Research ArticleArticles

Adjacent disc height reduction and clinical outcome after intradiscal cement leakage

Minjie Shen, Junjie Niu, Haifei Zhou, Qian Meng, Minfeng Gan and Huilin Yang
International Journal of Spine Surgery January 2016, 10 34; DOI: https://doi.org/10.14444/3034
Minjie Shen
First Affiliated Hospital of Soochow University, Suzhou, China
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Junjie Niu
First Affiliated Hospital of Soochow University, Suzhou, China
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Haifei Zhou
First Affiliated Hospital of Soochow University, Suzhou, China
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Qian Meng
First Affiliated Hospital of Soochow University, Suzhou, China
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Minfeng Gan
First Affiliated Hospital of Soochow University, Suzhou, China
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Huilin Yang
First Affiliated Hospital of Soochow University, Suzhou, China
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  • Fig. 1
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    Fig. 1

    Measurement of disc height (A) and disc diameter (B). Anterior disc height (Ha) and posterior disc height (Hp) were the shortest distances between the anterior and posterior edges of the neighboring endplates, respectively. Lines a and b (black lines) were drawn from the anterior and posterior endpoints of the superior vertebral endplate to the inferior, respectively. Disc diameter (DM, white line) was measured between the midpoints of line a and b.

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    Fig. 2

    A 70-year-old female who suffered from a vertebral compression fracture at T12. Lateral radiograph 19 months postoperatively (B) shows disc height reduction compared with the image one day after surgery (A). The Farfan index was 34.55% and 24.97% on lateral radiograph one day after surgery (A) and 19 months postoperatively (B), respectively.

Tables

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    Table 1

    Characteristics of patients, fractured vertebrae and surgeries.

    With Intradiscal Leakage (n=20)Without Intradiscal Leakage (n=104)P value
    Patient characteristics
    Age, year64.20±8.02465.78±8.13.427
    Sex, female17/2086/1041.000
    BMD (T-score)-2.88±0.44-2.72±0.39.105
    History of smoking3/2015/1041.000
    History of drinking alcohol1/2011/104.719
    Follow-up time, months19.80±2.9520.71±3.61.290
    Fracture characteristics
    Intravertebral cleft4/208/104.196
    Fracture age, wk.365
    ≤61483
    6-12412
    ≥1229
    Fracture location1.000
    Thoracolumbar region (T11-L2)1892
    Lower lumbar region (L3-L5)212
    Fracture type.480
    Wedge1485
    Biconcave412
    Crush27
    Fracture severity grade (%).428
    ≤25743
    25-40844
    ≥40517
    Endplate fracture.078
    absence230
    presence1874
    Surgical characteristics
    Total PMMA volume, ml5.78±0.805.08±0.97.003*
    • Abbreviations: BMD, bone mineral density; PMMA, polymethylmethacrylate.

    • ↵* P<0.05.

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    Table 2

    Baseline disc characteristics.

    With Intradiscal Leakage (n=20)Without Intradiscal Leakage (n=104)P value
    Preoperative modified Pfirrmann disc grade.799
    Grade 100
    Grade 2110
    Grade 31468
    Grade 4419
    Grade 517
    Baseline anterior disc height, mm8.11±2.508.49±3.23.865
    Baseline posterior disc height, mm4.24±1.154.19±1.92.194
    Baseline disc diameter, mm38.75±4.5740.71±4.30.066
    Baseline Farfan index (%)31.87±8.0130.51±8.77.521
    • View popup
    Table 3

    The results of disc height measurement.

    GroupAnterior disc height (mm)Posterior disc height (mm)Disc diameter (mm)Farfan index (%)DHRDHR rate (%)
    PostLastPPostLastPPostLastPPostLastP
    With Intradiscal Leakage8.11±2.505.62±2.11<0.0014.24±1.152.92±0.93<0.00138.75±4.5738.77±4.640.88131.87±8.0122.68±7.20<0.0019.19±2.8929.39±7.90
    Without Intradiscal Leakage8.49±3.237.39±2.99<0.0014.19±1.923.66±1.75<0.00140.71±4.3040.66±4.31<0.00130.51±8.7726.63±8.12<0.0013.88±2.7012.75±8.18
    Between Group P0.8650.0060.1940.0960.1020.1280.2830.036<0.001<0.001
    • Abbreviations: pos, one day after surgery (baseline); last, last follow-up; DHR, disc height reduction; DHR rate, disc height reduction rate.

    • View popup
    Table 4

    Clinical assessment using visual analog scale and Oswestry Disability Index.

    With Intradiscal Leakage (n=20)Without Intradiscal Leakage (n=104)
    Visual analogue scalepreoperative7.15±0.937.17±1.04
    pos2.30±0.73 a2.36±0.84a
    last2.80±0.62a2.60±0.65 a
    Oswestry disability indexpreoperative73.80±12.3169.90±13.69
    pos28.50±4.35 a27.23±5.91 a
    last30.90±3.28 a29.25±4.69 a
    • Abbreviations: pos, one day after surgery; last, last follow-up.

    • ↵a Compared with preoperative: P<0.05

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Adjacent disc height reduction and clinical outcome after intradiscal cement leakage
Minjie Shen, Junjie Niu, Haifei Zhou, Qian Meng, Minfeng Gan, Huilin Yang
International Journal of Spine Surgery Jan 2016, 10 34; DOI: 10.14444/3034

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Adjacent disc height reduction and clinical outcome after intradiscal cement leakage
Minjie Shen, Junjie Niu, Haifei Zhou, Qian Meng, Minfeng Gan, Huilin Yang
International Journal of Spine Surgery Jan 2016, 10 34; DOI: 10.14444/3034
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