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Abstract
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).
REFERENCES
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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.
Table 1.
Incidence of cement leakage according to vertebral body
| Site | Number(percentage) | Leakage on CT (percentage) |
|---|---|---|
| T10 | 4 | 0 |
| T11 | 14 | 4 |
| T12 | 31 | 8 |
| L1 | 38 | 15 |
| L2 | 32 | 15 |
| L3 | 18 | 7 |
| L4 | 4 | 3 |
| L5 | 7 | 4 |
| Total | 148 | 56 |
Table 2.
Classification of cement leakage
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