The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Incidence and risk factors of intraspinal bone cement leakage in percutaneous kyphoplasty

Author : ZHANG Shuai,WANG Qing, YANG Jin, LI Tao, XU Shuang, WANG Gao-ju.     
Working unit : Department of Spinal Surgery, The Affiliated Hospital of Southeast Medical University, Luzhou 646000, China
Page : 2244-2249
Key words : osteoporotic vertebral fracture, percutaneous kyphoplasty (PKP) , intraspinal bone cement leakage, risk factor
  Abstract: [Objective] To explore the incidence and risk factors of intraspinal bone cement leakage in percutaneous kyphoplasty (PKP) . [Methods] A retrospective study was performed on 474 patients (714 vertebrae) who underwent PKP from January 2008 to June 2017. Postoperative X ray and CT images were taken to determine whether or not intraspinal bone cement leakages happened, which were classified into type B, C and P based on the leakage path and intraspinal canal distribution. The related risk factors of intraspinal leakage were also searched. [Results] Of the 714 vertebrae, 52 vertebrae (7.28%) were confirmed intraspinal bone cement leakages, including type B in 29 vertebrae (55.77%) , type C in 15 vertebrae (28.85%) and type P in 8 vertebrae (15.38%) . Seven patients presented symptomatic intraspinal bone cement leakages, including 1 patient who got complete paralysis with AISA grade A that no any functional recovery achieved after decompression surgery in emergency, 1 patient who got incomplete paralysis that improved from AISA grade B to C after corresponding treatment, and 5 patients who had temporary neurological impairment that completely recovered by conservative therapy. The remaining 662 vertebrae were proved no intraspinal bone cement leakages. Compared the patients with and without intraspinal leakages, there were statistically significant differences regarding to volume of bone cement injected, fracture types, location surgically involved (P<0.05) . The multiple logical regress revealed that the volume of bone cement injected (OR=3.306, 95% CI=1.351~8.091, P<0.05) , fracture types (OR=4.910, 95%CI=1.551~15.544, P<0.05) , and surgical site (OR=0.453, 95%CI=0.219~0.939, P<0.05) were the factors related to intraspinal bone cement leakage. [Conclusion] The incidence of intraspinal bone cement leakages in PKP is 7.28%, associated with 0.98% symptomatic leakage among the 714 vertebrae. The volume of bone cement injected, fracture types, location surgically involved are the main factors related to the leakages.
summary:
Incidence and risk factors of intraspinal bone cement leakage in percutaneous kyphoplasty   
ZHANG Shuai,WANG Qing, YANG Jin, LI Tao, XU Shuang, WANG Gao-ju.
ϣ𡡣ʡã20182624   2244-2249