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What is the importance of “halo” phenomenon around bone cement following vertebral augmentation for osteoporotic compression fracture?

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Abstract

Summary

We investigated the importance, risk factors, and clinical course of the radiolucent “halo” phenomenon around bone cement following vertebral augmentation for osteoporotic compression fracture. Preoperative osteonecrosis and a lump cement pattern were the most important risk factors for the peri-cement halo phenomenon, and it was associated with vertebral recollapse.

Introduction

We observed a newly developed radiolucent area around the bone cement following vertebral augmentation for osteoporotic compression fractures. Here, we describe the importance of the peri-cement halo phenomenon, as well as any associated risk factors and long-term sequelae.

Methods

In total, 175 patients (202 treated vertebrae) were enrolled in this study. The treated vertebrae were subdivided into two groups: Group A (with halo, n = 32) and Group B (without halo, n = 170), and the groups were compared with respect to multiple preoperative (age, sex, BMD, preoperative osteonecrosis) and perioperative factors (operative approach: vertebroplasty or kyphoplasty; cement distribution pattern; cement leakage; cement volume), and postoperative results (VAS score, recollapse). Logistic regression analysis was used to evaluate the relationship between the incidence of the peri-cement halo and all of the parameters described above.

Results

Rates of osteonecrosis were also significantly higher in Group A than in Group B (62.5% vs. 31.2%, p < 0.05), and kyphoplasty (KP) was performed more frequently in Group A (43.8% vs. 17.6%, p < 0.05). Lump cement (93.8% vs. 30.6%, p < 0.05) and recollapse (78.1% vs. 24.7%, p < 0.05) were also more common among individuals in Group A. Logistic regression analysis also showed that preoperative osteonecrosis (OR = 3.679; 95% CI = 1.677–8.073; p = 0.001), KP (OR = 3.630; 95% CI = 1.628–8.095; p = 0.002), lump pattern (OR = 13.870; 95% CI = 2.907–66.188; p = 0.001), and vertebral recollapse (OR = 5.356; 95% CI = 1.897–15.122; p = 0.002) were significantly associated with peri-cement halo.

Conclusions

The peri-cement halo was found to be associated with vertebral recollapse, this sign likely represents a poor prognostic factor after vertebral augmentation for osteoporotic compression fractures.

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  1. Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eongu-ro, Gangnam-gu, Seoul, 135-720, Korea

    K. H. Kim, S. U. Kuh, J. Y. Park, K. S. Kim, D. K. Chin & Y. E. Cho

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  1. K. H. Kim
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  2. S. U. Kuh
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  3. J. Y. Park
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  4. K. S. Kim
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  5. D. K. Chin
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  6. Y. E. Cho
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Correspondence to D. K. Chin.

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Kim, K.H., Kuh, S.U., Park, J.Y. et al. What is the importance of “halo” phenomenon around bone cement following vertebral augmentation for osteoporotic compression fracture?. Osteoporos Int 23, 2559–2565 (2012). https://doi.org/10.1007/s00198-012-1896-y

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  • DOI: https://doi.org/10.1007/s00198-012-1896-y

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