Analysis on the risk factors of cement leakage in percutaneous kyphoplasty for Kümmell disease

English Keywords:Percutaneous kyphoplasty  Kümmell disease  Bone cement leakage  Risk factors

English Abstract:

  【Abstract】 Objectives: To identify the risk factors of bone cement leakage in percutaneous kyphoplasty (PKP) in patients with Kümmell disease. Methods: A total of 70 patients with Kümmell disease treated with PKP in our hospital between February 2016 and March 2021 were retrospectively reviewed. According to whether there was bone cement leakage in operation or not, the patients were divided into leakage group and non-leakage group. Age, gender, body mass index(BMI), staging of Kümmell disease(Ⅰ/Ⅱ), symptom duration, fracture site(thoracic, lumbar), cement volume, cement distribution pattern (lumped, spongy), anterior and posterior wall heights, the decrease of anterior vertebral wall height, compression degree of anterior wall, wedge angle and the volume fraction of bone cement were recorded. The data were analyzed by univariate and multivariate Logistic regression analysis to determine the related factors of cement leakage. Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of bone cement volume fraction on bone cement leakage. Results: Bone cement leakage occurred in 32 of 70 patients, with a leakage rate of 45.7%. Univariate analysis showed that there were significant differences in the staging of Kümmell disease(Ⅰ/Ⅱ), the compression degree of anterior wall, wedge angle, and the volume fraction of bone cement between groups(P<0.05). Logistic regression analysis showed that the compression degree of anterior wall(P=0.021) and the volume fraction of bone cement(P=0.032) were the risk factors of bone cement leakage after PKP treatment of Kümmell disease. ROC curve showed that the best critical value of the volume fraction of bone cement to predict bone cement leakage was 31.28%. Conclusions: The compression degree of anterior wall and the volume fraction of bone cement are independent risk factors for bone cement leakage in PKP treatment of Kümmell disease, and the volume fraction of bone cement should be kept below 31.28%.