Retrospective Analysis Of The Relationship Between The Leakage Of Bone Cement And The Vascular Anatomy Of The Thoracolumbar Vertebral Body

Background: Previous studies show that the bone cement leakage rate is associated with surgical procedure of PKP and vertebral venous distribution.Objective: To identify a potential way to prevent cement leakage by studying the distribution rule of thoracolumbar vessels and the bone correlation between cement leakage rate and surgical procedure.Methods: 105 patients from our Hospital treated with PKP for osteoporotic vertebral compression fractures(OVCF)were retrospectively reviewed.All patients were divided into three groups according to the puncture angle: oblique downward position(Group A),horizontal position(Group B)and oblique upward position(Group C).In the second study,the patients were divide into 3 groups according to the injection site of PMMA: left side of safety zone(Group 1),safety zone(Group 2)and right side of safety zone(Group 3).The correlation between cement leakage rate and puncture techniques was studied.Results and conclusion: Among 105 patients with OVCF who underwent PKP,the total bone cement leakage rate was 30.7%.The bone cement leakage rate and type S(via the segmental vein)leakage rate in Group A were lower than Group B and C.The differences were of statistical significance(P<0.05).In the second study,the bone cement leakage rate and type S(via the segmental vein)leakage rate in Group 2 were significantly lower than Group 1 and 3.The differences were of statistical significance(P<0.05).The results from this study confirm the existence of “safety zone” in vertebra and indicate that management of puncture angel and injection site of PMMA can potentially decrease the cement leakage rate.