Cement Leakage after Vertebroplasty; Correlation with Patterns of Compression Fractures and Bone Mineral Density (BMD)

ABSTRACT

STUDY DESIGN: Retrospective study. OBJECTIVES: To analyze the influence of fracture patterns and the result of bone mineral density on cement leakage after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. SUMMARY OF LITERATURE REVIEW Leakage of bone cement after vertebroplasty has known to be related with the direction of cortical disruption of fractured vertebral body and low bone mineral density (BMD). MATERIALS AND METHODS: One hundred eighty-two patients with osteoporotic vertebral compressions were studied from January 2009 to August 2013. The patients' fracture levels and patterns were compared. Among them, the cement leakage patterns were analyzed in 105 patients who had undergone vertebroplasty. The findings were compared with fracture patterns including cortical disruption and BMD. RESULTS: Seventy-five cases of cement leakage were observed. Among them, intradiscal leakage was the most common type of leakage. In the patient group with low BMD, there was a high incidence of lower and posterior cortical disruption in the fractures. Patients with posterior cortical disruption demonstrated a higher incidence of leakage into the spinal canal and anterior cortex. No significant correlation was observed between fracture patterns and leakage. CONCLUSIONS: A surgeon should use caution in performing vertebroplasty in patients with low BMD and posterior disruption of the vertebral cortex.