J Korean Soc Spine Surg.  2010 Mar;17(1):13-17. 10.4184/jkss.2010.17.1.13.

Factor Analysis Affecting the Leakage of Bone Cement After Vertebroplasty

• Kim JH
• Song KJ
• Kim TS
• Cho JL
• Park YS

• KMID: 2003094
• DOI: http://doi.org/10.4184/jkss.2010.17.1.13

Abstract

STUDY DESIGN: Retrospective study OBJECTIVE: This study examined the causative factors of cement leakage in an osteoporotic compression fracture that had received percutaneous vertebroplasty. SUMMARY OF LITERATURE REVIEW: Percutaneous vertebroplasty is simple and safe for the treatment of osteoporotic compression fractures. However, serious complications, such as pulmonary emboli and paraplegia, can occur if the bone cement leaks into the pulmonary artery or spinal canal.
MATERIALS AND METHODS
Between Oct. 2002 and Apr. 2008, 95 patients (148 vertebral bodies) underwent percutaneous vertebroplasty for the treatment of an osteoporotic compression fracture. The presence of cement leakage was evaluated by plain radiography and computed tomography. The correlations between cement leakage and gender, age, level of fractured vertebra, fracture type, bone density, procedure, injecting amount, preoperative vertebral body compression rate, timing of surgery, and the existence of an intravertebral cleft on magnetic resonance imaging (MRI) were analyzed.
RESULTS
Leakage was found in 37 bodies on plain radiography and 56 on the CT-scan. A comparison of the leakage and non-leakage groups revealed the bone density (p=0.046) and amount injected (p=0.000) to be related to cement leakage. Multivariate logistic regression showed that injecting more than 4.0ml was related to cement leakage with an odds ratio of 2.23(95% CI, 1.476~3.377).
CONCLUSIONS
Cement leakage after percutaneous vertebroplasty is associated with the amount injected. Therefore, the cement volume should be restricted to the amount required for pain relief.

Keyword

Vertebroplasty; Cement leakage

MeSH Terms

Bone Density
Factor Analysis, Statistical*
Fractures, Compression
Humans
Logistic Models
Magnetic Resonance Imaging
Odds Ratio
Paraplegia
Pulmonary Artery
Radiography
Retrospective Studies
Spinal Canal
Spine
Vertebroplasty*

Figure

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  Fig. 1. (A) An 66-year-old female has recent osteoporotic compression fracture of L3. (B) Postoperative Lateral roentgenogram and Computed tomography (CT) show leakage of PMMA.

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