Analysis of the Incidence of and Prevention Strategies for Bone Cement Leakage after Percutaneous Vertebroplasty or Kyphoplasty_West China Medical Journal

Authors：

 WANGXin-hu , ZHANGJun , LIUXia-jun , HUANYuan-chi , DUWei , YAOFu-dong

Department of Spine, Baoji Municipal Central Hospital, Baoji, Shaanxi 721008, P. R. China;

Corresponding author：

Keywords：

Percutaneous vertebroplasty; Percutaneous kyphoplasty; Osteoporosis; Vertebral compression fractures

DOI：

10.7507/1002-0179.20150188

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Objective To analyze the incidence of and prevention strategies for bone cement leakage after percutaneous vertebroplasty (PVP) or kyphoplasty (PKP) for treatment of osteoporotic vertebral compression fractures. Methods A retrospective analysis was carried out on the clinical data of 178 patients who had 268 thoracolumbar osteoporotic compressions and underwent PVP or PKP from January 2010 to January 2013 in our hospital. We analyzed the causes of and prevention strategies for bone cement leakage. The therapeutic effect was observed after operation. We summarized the causes and prevention strategies for the bone cement leakage. Results Statistics showed that 51 vertebrae (19.0%) had bone cement leakage, including 31 vertebrae (29.2%) after PVP and 20 vertebrae (12.3%) after PKP. All patients had back pain relief after operation. One patient with bone cement leakage had the nerve root injured, which was relieved by decompression. Other patients had no reaction. Conclusion The causes of cement leakage were related to the patients' own factors, but were more related to the operations. Adequate preparation before operation, correct surgical technology during operation, taking necessary precautions and X-ray monitoring are the key to the prevention of cement leakage.

Citation： WANGXin-hu, ZHANGJun, LIUXia-jun, HUANYuan-chi, DUWei, YAOFu-dong. Analysis of the Incidence of and Prevention Strategies for Bone Cement Leakage after Percutaneous Vertebroplasty or Kyphoplasty. West China Medical Journal, 2015, 30(4): 648-651. doi: 10.7507/1002-0179.20150188 Copy

1.	郑召民, 李佛保. 经皮椎体成形术和经皮椎体后凸成形术——问题与对策[J]. 中华医学杂志, 2006, 86(27):1878-1880.
2.	Hadjipavlou AG, Tzermiadianos MN, Katonis PG, et al. Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours[J]. J Bone Joint Surge Br, 2005, 87(12):1595-1604.
3.	Phillips FM. Minimally invasive treatments of ostesoporotin verbtebral compression fractures[J]. Spine (Phila Pa 1976), 2003, 28(Suppl 15):45-53.
4.	Papadopoulos EC, Edobor-Osula F, Gardner MJ, et al. Unipedieular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures:early results[J]. J Spinal Disord Tech, 2008, 21(8):589-596.
5.	Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral comprssion fractures:identification or risk fractors[J]. Spine (Phila Pa 1976), 2011, 11(9):839-848.
6.	Anselmetti GC, Muto M, Guglielmi G, et al. Percutaneous vertebroplasty or kyphoplasty[J]. Radiol Clin North Am, 2010, 48(3):641-649.
7.	Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures[J]. J Bone Joint Surg Br, 2003, 85(1):83-89.
8.	童培建, 黄忠名, 厉驹, 等. 经皮椎体后凸成形术并发骨水泥渗漏防治的探讨[J]. 中华外科杂志, 2007, 45(20):1432-1433.
9.	何明基, 练辉, 申刚, 等. 经皮椎体成形术并发症分析及防治策略[J]. 当代医学:中国介入放射学, 2008, 2(1):67-69.
10.	杨丰建, 林伟龙, 朱炯, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折[J]. 中国脊柱脊髓杂志, 2011, 21(1):50-54.
11.	杨惠林, 牛国旗, 王根林, 等. 椎体后凸成形术治疗周壁破损的骨质疏松性椎体骨折[J]. 中华骨科杂志, 2006, 26(3):165-169.
12.	杨益民, 任志伟, 李萌, 等. 选择性应用陶瓷人工骨在椎体后凸成形中预防骨水泥渗漏的作用[J]. 西安交通大学学报:医学版, 2012, 33(4):494-497.
13.	郑召民. 经皮椎体成形术和经皮椎体后凸成形术灾难性并发症——骨水泥渗漏及其预防[J]. 中华医学杂志, 2006, 86(43):3027-3030.
14.	徐建广, 吴春根. CT引导下经皮椎体成形术治疗胸椎转移性肿瘤[J]. 中国脊柱脊髓杂志, 2009, 19(5):341-344.
15.	张建党, 邹德威, 马华松, 等. 应用Fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折[J]. 中国脊柱脊髓杂志, 2011, 21(3):193-196.

1. 郑召民, 李佛保. 经皮椎体成形术和经皮椎体后凸成形术——问题与对策[J]. 中华医学杂志, 2006, 86(27):1878-1880.
2. Hadjipavlou AG, Tzermiadianos MN, Katonis PG, et al. Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours[J]. J Bone Joint Surge Br, 2005, 87(12):1595-1604.
3. Phillips FM. Minimally invasive treatments of ostesoporotin verbtebral compression fractures[J]. Spine (Phila Pa 1976), 2003, 28(Suppl 15):45-53.
4. Papadopoulos EC, Edobor-Osula F, Gardner MJ, et al. Unipedieular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures:early results[J]. J Spinal Disord Tech, 2008, 21(8):589-596.
5. Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral comprssion fractures:identification or risk fractors[J]. Spine (Phila Pa 1976), 2011, 11(9):839-848.
6. Anselmetti GC, Muto M, Guglielmi G, et al. Percutaneous vertebroplasty or kyphoplasty[J]. Radiol Clin North Am, 2010, 48(3):641-649.
7. Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures[J]. J Bone Joint Surg Br, 2003, 85(1):83-89.
8. 童培建, 黄忠名, 厉驹, 等. 经皮椎体后凸成形术并发骨水泥渗漏防治的探讨[J]. 中华外科杂志, 2007, 45(20):1432-1433.
9. 何明基, 练辉, 申刚, 等. 经皮椎体成形术并发症分析及防治策略[J]. 当代医学:中国介入放射学, 2008, 2(1):67-69.
10. 杨丰建, 林伟龙, 朱炯, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折[J]. 中国脊柱脊髓杂志, 2011, 21(1):50-54.
11. 杨惠林, 牛国旗, 王根林, 等. 椎体后凸成形术治疗周壁破损的骨质疏松性椎体骨折[J]. 中华骨科杂志, 2006, 26(3):165-169.
12. 杨益民, 任志伟, 李萌, 等. 选择性应用陶瓷人工骨在椎体后凸成形中预防骨水泥渗漏的作用[J]. 西安交通大学学报:医学版, 2012, 33(4):494-497.
13. 郑召民. 经皮椎体成形术和经皮椎体后凸成形术灾难性并发症——骨水泥渗漏及其预防[J]. 中华医学杂志, 2006, 86(43):3027-3030.
14. 徐建广, 吴春根. CT引导下经皮椎体成形术治疗胸椎转移性肿瘤[J]. 中国脊柱脊髓杂志, 2009, 19(5):341-344.
15. 张建党, 邹德威, 马华松, 等. 应用Fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折[J]. 中国脊柱脊髓杂志, 2011, 21(3):193-196.

West China Medical Journal

Analysis of the Incidence of and Prevention Strategies for Bone Cement Leakage after Percutaneous Vertebroplasty or Kyphoplasty

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