Importance of the peridural membrane in percutaneous vertebroplasty

Objective: The peridural membrane is a fibrous membrane that lies anterior to the posterior longitudinal ligament and attaches to its deep layer. It spans the width of the vertebral body and encircles the bony canal around the outside of the dura. The purpose of this study was to determine if the peridural membrane helps contain posterior cement leakage during percutaneous vertebroplasty. Methods: Compression fractures were experimentally created in cadaveric spines. The bodies were stabilized using bipedicular injection of cement, and injection was continued until cement was evident beyond the posterior border of the vertebral body. The vertebral segments were then dissected and the extravasated cement localized anatomically. Conclusions: All extravasated cement was constrained by the peridural membrane, and no direct contact of the cement with the dura was seen.