Research advanced on bone cement leakage after percutaneous vertebroplasty for thoracolumbar osteoporotic fractures / 中华骨科杂志

ABSTRACT

Bone cement leakage is the most common complication in the treatment of thoracolumbar osteoporotic fractures by percutaneous vertebroplasty.The incidence rates of the literatures are different,with the range from 5％ to 80％.There are several different classifications of cement leakage;however there is no uniform classification standard.The classification criteria' s are based on anatomical location and leakage way.The independent risk factors of cement leakage are fracture semiquantitative severity grade and the viscosity of bone cement.The incidence rate of cement leakage increases with high fracture semiquantitative severity grade and low bone cement viscosity.For cortical leakage,the presence of cortical disruption and intravertebral cleft on MRI were identified as additional strong risk factors.The majority of bone cement leakage does not produce clinical symptoms.But some of the patients suffered from new adjacent osteoporotic vertebral compression fractures,neurologic deficits,pulmonary cement emboli,cardiac perforation,and even death.Therefore,we should strictly grasp the indications,select appropriate filling materials,and improve surgical techniques to avoid the occurrence of bone cement leakage.