Unipedicle percutaneous vertebroplasty for spinal intraosseous vacuum cleft

Osteoporotic compression fractures have been widely treated by vertebroplasty through a bipedicle approach. We suspected that a compression fracture with vacuum cleft can be treated successfully with a unipedicle approach. We retrospectively reviewed 27 patients with an osteoporotic compression fracture with intraosseous vacuum cleft. The patients received percutaneous vertebroplasty with bone cement (polymethylmethacrylate) augmentation. Bone cement was injected into the fractured vertebral body through only one cannula in the selected pedicle. Cement filling, vertebral height restoration, and relief of pain were evaluated. The minimum followup was 12 months (range, 12-30 months). Twenty six of 27 patients had adequate filling. Average vertebral height restoration was 27%. The patients' visual analog scale improved an average of 40 points. Percutaneous transpedicle vertebroplasty is effective for treating osteoporotic compression fractures with intraosseous vacuum clefts. Because of the preexistent cleft, the procedure can be done successfully via a unipedicle approach. Level of Evidence: Therapeutic study, Level IV (case series-no, or historical, control group). See the Guidelines for Authors for a complete description of levels of evidence.