Analysis Of Factors Related To Bone Cement Leakage After Percutaneous Kyphoplasty And Its Prevention And Treatment

To reduce the leakage rate of bone cement after operation and to provide reference for the future operation.In this paper,we will study some factors of bone cement leakage after kyphoplasty.53 patients(75 patients with OVCF)who were treated in our hospital from November 2015 to November 2017 were selected.According to the postoperative imaging whether there was bone cement leakage,two groups were divided into two groups: group A(leakage group),group B(non-leakage group).Related factors: the study of factors related to bone cement leakage after PKP has been reported in a large number of literatures,among which the related factors studied include timing of bone cement injection,preoperative Cobb angle,In this paper,we analyzed the relative few puncture times,bone mineral density,vertebral fracture and other factors.The related factors in group A and group B were as follows: preoperative VAS score,age,sex,and so on.Anterior height of vertebral body,bone mineral density,vertebral body The condition of fracture,the way of puncture,the times of puncture,the quantity of bone cement injected were compared statistically to determine whether it was a risk factor of vertebral leakage after PKP.All patients underwent PKP surgery,there were no serious complications such as pulmonary embolism.According to the imaging results,the vertebrae were divided into 21 vertebrae in group A and 54 in group B.Among them,the leakage sites of 21 vertebrae were respectively.There were 10 cases of intervertebral space.There were 7 cases of paravertebral soft tissue,3 cases of pedicle needle approach and 1 case of vertebral canal.The leakage rate was 28.00%.Spinal nerve compression symptoms accordingly,it did not give drug treatment,postoperative follow-up observation.Univariate analysis showed that the A group in the preoperative VAS score(8.71 + 0.24),ODI score(85 + 1.27),age(71.29 + 2.19),bone density(2.61 + 0.14)SD and B group in the preoperative VAS score(8.94 + 0.14),ODI score(85.78 + 0.69),age(71.50 + 1.67),bone density(2.57 + 0.12)SD had no significant difference in group A(P > 0.05),while in group A,the anterior height of vertebral body was(53.29 ±2.53),the amount of bone cement injected was(6.43 ±0.28)ml,the times of puncture was(8.14 ±0.37)and the height of anterior edge of vertebral body in group B was(63.57 ±0.88),and the quantity of bone cement injected was(63.57 ±0.88).Compared with(4.03 ±0.17)ml,(5.03 ±0.22)times of puncture and fracture of vertebral body,(P=0.002)had Statistical significance was significant(P < 0.05),which were the risk factors of vertebral leakage after PKP.The multivariate Logistic regression analysis of the significant factors in t test analysis showed that,The height of the anterior edge of the vertebra was(P=0.031),the quantity of bone cement injected was(P=0.039),and the condition of vertebral fracture was(P=0.033)(P < 0.05).The independent risk factor of bone cement leakage after PKP is the height of the loss of the anterior edge of the vertebral body before and after the operation,and the fracture of the vertebral body is a separate risk factor(P < 0.05)after the operation of PKP,the risk factor for the leakage of bone cement is the height of the loss of the anterior edge of the vertebral body.Amount of bone cement injected,vertebral fracture,The occurrence of bone cement leakage can be reduced by carefully selecting the appropriate patient before operation,properly sealing the damaged perivertebral wall,injecting appropriate amount of bone cement during the operation,and using the new operative method.