Complications and the prevention of percutaneous kyphoplasty for osteoporotic vertebral compression fractures

English Keywords:Ｖertebral compression fractures  Ｐercutaneous kyphoplasty  Osteporosis  Complication  Prevention

English Abstract:

  【Abstract】　Objective：To summarized the complications and the prevention of percutaneous kyphoplasty（PKP） for osteoporotic vertebral compression fractures（OVCFs）.Method：From June 2003 to December 2009，a total of 233 vertebrae in 187 patients（31 males and 156 females） aged from 52 to 93 years underwent PKP.All cases presented with no neurological deficit.The peripheral wall of 47 vertebral bodies were noted broken in 34 cases，while 186 vertebral bodies in 153 cases were intact.The involved vertebrae included T5~L5，and transpedicular approach was performed in vertebrae below T10，while parapedicular approach was performed in vertebrae above T9.All patients were followed up for an average of 20.8 months（range，2-28 months）.Result：Complications were noted in 23 cases（12.3%）.Bone cement leakage was noted in 7 vertebrae（7 cases），and 6 cases had no symptoms.1 case had no pain relief after operation，but the pain was alleviated after 3d NSAID administration.The bone cement leaking rate for broken and intact of peripheral wall was 8.5%（4/47） and 1.6%（3/186） respectively，which showed significant difference（P<0.05）.The volume of bone cement injection in leaking vertebrae was 4.53±0.31ml and 6.75±0.42ml for thoracic spine and lumbar spine respectively，while 3.50±0.40ml and 5.60±0.60ml respectively for no leaking vertebrae，which showed significant difference be?鄄tween 2 groups with regard to the volume of bone cement injection（P<0.05）.No difference of approach-related and site-related bone cement leaking was noted（P>0.05）.3 cases had transient hypertension，which was resolved after corresponding intervention 30min later，2 cases had no pain relief，which was resolved after administration of NSAID for 2d and 7d respectively，5 cases had fever，which was resolved after corresponding intervention.6 cases were noted fresh fracture in nonsurgical vertebrae，and 4 underwent conservative treatment and 2 underwent PKP again.All recovered to routine activity.Conclusion：Cement leakage is still the main and potential complication of PKP.It should be kept in mind that improved surgical technique and strict indication can ensure the success of PKP.