Risk factors for cement leakage in percutaneous vertebroplasty for Kümmell disease / 中华骨科杂志

ABSTRACT

Objective:To identify risk factors for cement leakage in percutaneous vertebroplasty (PVP) for Kümmell disease.Methods:A total of 309 patients (351 levels) with Kümmell disease who underwent PVP between November 2015 and June 2019 were retrospectively reviewed. Age, gender, time of symptom onset, staging of Kümmell disease, fracture site(thoracic, lumbar), cortical disruption, type of fracture (wedge, biconcave, crush), fracture severity (mild, moderate, severe), intrusion of posterior wall, basivertebral foramen, puncture approach (unilateral, bilateral), cement distribution pattern (lumped, spongy), cement volume, cement leakage (yes, no) and cement leakage type were recorded. Cement leakage was classified into three types through the basivertebral vein, through the cortical defect, and through the segmental vein. The data was analyzed by univariate and multivariate analysis to determine related factors of cement leakage in general and each type.Results:The rate of overall leakage was 65.8% (231/351). The leakage rate of basivertebral vein type, cortical defect type, and segmental vein type was 21.4% (75/351), 37.6% (132/351) and 22.8% (80/351), respectively. Multivariate analysis showed that three significant factors related to leakage in general were cortical disruption, basivertebral foramen and cement distribution pattern. Significant factors related to basivertebral vein type leakage were basivertebral foramen and cement distribution pattern. Significant factors related to cortical defect type leakage were cortical disruption and cement distribution pattern. Significant factors related to segmental vein type leakage were basivertebral foramen, cement distribution pattern, cement volume and fracture site.Conclusion:Risk factors of cement leakage in PVP for Kümmell disease include cortical disruption, basivertebral foramen and cement distribution pattern.