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

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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, 黃忠名, 厲駒, 等. 經皮椎體后凸成形術并發骨水泥滲漏防治的探討[J]. 中華外科雜志, 2007, 45(20):1432-1433.
9.	何明基, 練輝, 申剛, 等. 經皮椎體成形術并發癥分析及防治策略[J]. 當代醫學:中國介入放射學, 2008, 2(1):67-69.
10.	楊豐建, 林偉龍, 朱炯, 等. 經皮椎體成形術和經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折[J]. 中國脊柱脊髓雜志, 2011, 21(1):50-54.
11.	楊惠林, 牛國旗, 王根林, 等. 椎體后凸成形術治療周壁破損的骨質疏松性椎體骨折[J]. 中華骨科雜志, 2006, 26(3):165-169.
12.	楊益民, 任志偉, 李萌, 等. 選擇性應用陶瓷人工骨在椎體后凸成形中預防骨水泥滲漏的作用[J]. 西安交通大學學報:醫學版, 2012, 33(4):494-497.
13.	鄭召民. 經皮椎體成形術和經皮椎體后凸成形術災難性并發癥——骨水泥滲漏及其預防[J]. 中華醫學雜志, 2006, 86(43):3027-3030.
14.	徐建廣, 吳春根. CT引導下經皮椎體成形術治療胸椎轉移性腫瘤[J]. 中國脊柱脊髓雜志, 2009, 19(5):341-344.
15.	張建黨, 鄒德威, 馬華松, 等. 應用Fabric pod行椎體后凸成形術治療骨質疏松性椎體骨折[J]. 中國脊柱脊髓雜志, 2011, 21(3):193-196.

1. 鄭召民, 李佛保. 經皮椎體成形術和經皮椎體后凸成形術——問題與對策[J]. 中華醫學雜志, 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, 黃忠名, 厲駒, 等. 經皮椎體后凸成形術并發骨水泥滲漏防治的探討[J]. 中華外科雜志, 2007, 45(20):1432-1433.
9. 何明基, 練輝, 申剛, 等. 經皮椎體成形術并發癥分析及防治策略[J]. 當代醫學:中國介入放射學, 2008, 2(1):67-69.
10. 楊豐建, 林偉龍, 朱炯, 等. 經皮椎體成形術和經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折[J]. 中國脊柱脊髓雜志, 2011, 21(1):50-54.
11. 楊惠林, 牛國旗, 王根林, 等. 椎體后凸成形術治療周壁破損的骨質疏松性椎體骨折[J]. 中華骨科雜志, 2006, 26(3):165-169.
12. 楊益民, 任志偉, 李萌, 等. 選擇性應用陶瓷人工骨在椎體后凸成形中預防骨水泥滲漏的作用[J]. 西安交通大學學報:醫學版, 2012, 33(4):494-497.
13. 鄭召民. 經皮椎體成形術和經皮椎體后凸成形術災難性并發癥——骨水泥滲漏及其預防[J]. 中華醫學雜志, 2006, 86(43):3027-3030.
14. 徐建廣, 吳春根. CT引導下經皮椎體成形術治療胸椎轉移性腫瘤[J]. 中國脊柱脊髓雜志, 2009, 19(5):341-344.
15. 張建黨, 鄒德威, 馬華松, 等. 應用Fabric pod行椎體后凸成形術治療骨質疏松性椎體骨折[J]. 中國脊柱脊髓雜志, 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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