Eur Rev Med Pharmacol Sci 2023; 27 (9): 3877-3886
DOI: 10.26355/eurrev_202305_32293

Factors affecting cement leakage in percutaneous vertebroplasty: a retrospective cohort study of 309 patients

J.-G. Hou, N. Zhang, G.-D. Chen

Department of Orthopedics, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China. znqhddyyy@163.com


OBJECTIVE: Percutaneous vertebroplasty has been widely applied as a treatment for osteoporotic vertebral compression fracture. However, the incidence of cement leakage is high. The purpose of study is to identify the independent risk factors for cement leakage.

PATIENTS AND METHODS: A total of 309 patients who suffered from osteoporotic vertebral compression fracture (OVCF) and underwent percutaneous vertebroplasty (PVP) were enrolled in this respective cohort study from January 2014 to January 2020. Clinical and radiological characteristics were assessed to identify independent predictors for each type of cement leakage, including age, gender, course of disease, fracture level, morphology of vertebral fracture, fracture severity, cortical disruption in vertebral wall or endplate, fracture line connected with basivertebral foramen, type of cement dispersion, and intravertebral cement volume.

RESULTS: In leakage of B-type, fracture line connected with basivertebral foramen was identified as an independent risk factor [Adjusted OR: 2.837, 95% CI: (1.295, 6.211), p = 0.009]. For leakage of C-type, acute course of the disease, more severity of the fractured body, wall disruption and intravertebral cement volume (IVCV) were identified as independent risk factors [Adjusted OR: 0.409, 95% CI: (0.257, 0.650), p = 0.000]; [Adjusted OR: 3.128, 95% CI: (2.202, 4.442), p = 0.000]; [Adjusted OR: 6.387, 95% CI: (3.077, 13.258), p = 0.000]; [Adjusted OR: 1.619, 95% CI: (1.308, 2.005), p = 0.000]. Regarding leakage of D-type, biconcave fracture and endplate disruption were identified as independent risk factors [Adjusted OR: 6.499, 95% CI: (2.752, 15.348), p = 0.000]; [Adjusted OR: 3.037, 95% CI: (1.421, 6.492), p = 0.004]. For S-type, fracture in thoracic level and less severity of the fractured body were identified as independent risk factors [Adjusted OR: 0.105, 95% CI: (0.059, 0.188), p = 0.000]; [Adjusted OR: 0.580, 95% CI: (0.436, 0.773), p = 0.000].

CONCLUSIONS: Cement leakage was very common with PVP. Each cement leakage had its own influence factors. Preoperative identification of above influence factors for cement leakage could avoid the occurrence of severe sequelae.

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To cite this article

J.-G. Hou, N. Zhang, G.-D. Chen
Factors affecting cement leakage in percutaneous vertebroplasty: a retrospective cohort study of 309 patients

Eur Rev Med Pharmacol Sci
Year: 2023
Vol. 27 - N. 9
Pages: 3877-3886
DOI: 10.26355/eurrev_202305_32293