The Complications And Preventions Of Bone Cement Leakage In Percutaneous Kyphoplasty

Objective Discuss the complications and preventions of bone cement leakage after percutaneous kyphoplasty,in order to reduce the incidence and consequences of complications.Methods Retrospectively reviewed 128 patients who underwent PKP for OVCFs from October 2013 to December 2015 in the First Affiliated Hospital of Fujian Medical University.The correlative factors including sex,age,vertebral level treated,preoperative degree of vertebral compression,the integrality of vertebral body wall,cement volume injected,postoperative regain of vertebral compression,the graded of Vas,postoperative improvement rate of Vas.And record the complications and treatment related to bone cement leakage. For the above data,using T test,Chi-square test for univariate analysis, Logistic regression for multivariate analysis.Result In the 128 patients, 16 patients shows the bone cement leakage images after percutaneous kyphoplasty,by computing a total of 146 vertebral bone,the cement leakage rate was 11.0%(16 vertebraes), leakage site: penetrate into the vertebral disc 6 cases(4.1%), penetrate into the vertebral vein 1 case(0.7%);penetrate into the tissue around vertebral 6 cases(4.1%); penetrate into the needle track 1 case(0.7%); penetrate the vertebral canal 2 cases(1.37%), all without clinical symptoms,The bowel and bladder function or the motor and sensory function of lower extremity are barrier-free, no clinical sequelae during follow-up.The postoperative VAS score improvement and restoration of vertebral height was statistically significant(P <0.05). Between the leakage group and the non-leakage group,the univariate analysis showed that the difference of the cement volume and the integrality of vertebral body wall was statistically significant(P <0.05),the bone cement volume of thoracic under 3.6ml and that of lumbar under 4.3ml can reduce the incidence of bone cement leakage. the two groups of patients before surgery vertebral compression ratio, surgery Comparative results of vertebral body and the recovery rate was not statistically significant(P> 0.05). Multivariate Logistic regression analysis showed that the volume of bone cement injection(P<0.01,OR=5.949,95%CI=2.634-13.433) and the integrality of vertebral body wall(P<0.01,OR=10.653,95%CI=2.573–44.111) is a key factor of the bone cement leakage.Conclusion Percutaneous kyphoplasty can restore some vertebral height and has a significant analgesic effect, its main complication is the leakage of bone cement, the key factors for its occurrence is the volume of bone cement and the integrality of vertebral body wall. Improve the preoperative preparation,surgery operation standard and the postoperative management can reduce the incidence and consequences of complications.