Risk factors for cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures in octogenarians

English Keywords:Osteoporotic vertebral compression fracture  Percutaneous vertebroplasty  Cement leakage  Risk factors

English Abstract:

  【Abstract】 Objectives: To identify risk factors for cement leakage in percutaneous vertebroplasty(PVP) for osteoporotic vertebral compression fractures(OVCFs) in octogenarians. Methods: A total of 236 patients aged at 80 or more who underwent PVP at 344 levels for OVCFs between November 2015 and June 2019 were retrospectively reviewed. Data included age, gender, onset of symptoms(acute, subacute, chronic), trauma, fracture level(mid-thoracic, lower thoracic, lumbar), cortical disruption, cleft sign, type of fracture(wedge, biconcave, crush), fracture severity(mild, moderate, severe), intrusion of posterior wall, basivertebral foramen, puncture approach (unilateral, bilateral), cement distribution pattern (trabecular, cleft), cement volume, type of cement leakage was recorded. Cement leakage was classified into three types: through the basivertebral vein(B-type), through the cortical defect(C-type), through the segmental vein(S-type). The data were analyzed by univariate and multivariate analysis to determine related factors for B-type, C-type and S-type cement leakage. Results: The rate of B-type, C-type and S-type leakage was 28.5%(98/344), 24.4%(84/344) and 34.3%(118/344), respectively. Multivariate analysis showed that two significant factors related to B-type leakage were cement distribution pattern and basivertebral foramen. One significant factor related to C-type leakage was cortical disruption. Six significant factors related to S-type leakage were cement distribution pattern, basivertebral foramen, cleft, fracture severity, intrusion of posterior wall and gender. Conclusions: In PVP for OVCFs in octogenarians, each different cement leakage has its own risk factors; Identification of risk factors for cement leakage might be helpful inreducing the rate of cement leakage.