Department of Orthopedic Surgery, Shijiazhuang People's Hospital, Shijiazhuang, Hebei, China (mainland).
Med Sci Monit. 2022 Mar 28;28:e935080. doi: 10.12659/MSM.935080.
BACKGROUND Cement leakage is the most common complication following percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs). Dynamic fracture mobility was determined by comparing preoperative standing lateral radiographs with intraoperative prone lateral radiographs. This retrospective study from a single center aimed to evaluate the effect of dynamic fracture mobility on cement leakage in PVP and PKP in 286 patients with OVCFs. MATERIAL AND METHODS Records of patients who underwent PVP or PKP in our department between January 2016 and December 2019 were retrospectively analyzed, showing that 156 patients received PVP and 130 patients received PKP. Variables that were significantly related to presence of cement leakage in the univariate analysis were subsequently included in a multivariate logistic regression analysis for determining the independent risk factors for cement leakage. RESULTS The univariate analysis showed that dynamic fracture mobility (P<0.001), operative approach (P=0.026), peripheral vertebrae wall damage (P<0.001), intravertebral cleft (P<0.001), and cement volume injected (P<0.001) were correlated with cement leakage. Factors that showed differences by univariate analysis underwent multivariate logistic regression analysis, showing that peripheral vertebrae wall damage (OR=11.774,95% CI 4.384-31.619, P=0.000), dynamic fracture mobility (OR=5.884, 95% CI 2.295-15.087, P=0.000), operative approach (OR=3.143, 95% CI 1.136-8.698, P=0.027), and cement volume injected (OR=1.486, 95% CI 1.119-1.973, P=0.006) were independent risk factors for postoperative cement leakage. CONCLUSIONS This retrospective study showed that dynamic fracture mobility, peripheral vertebrae wall damage, operative approach, and cement volume injected were risk factors for cement leak following PVP and PKP.
骨水泥渗漏是经皮椎体成形术（PVP）和经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折（OVCF）后最常见的并发症。通过比较术前站立侧位 X 线片与术中俯卧位侧位 X 线片来确定动态骨折活动度。本研究为单中心回顾性研究，旨在评估 286 例 OVCF 患者中，动态骨折活动度对 PVP 和 PKP 中骨水泥渗漏的影响。
回顾性分析我院 2016 年 1 月至 2019 年 12 月期间行 PVP 或 PKP 的患者，其中 156 例行 PVP，130 例行 PKP。单因素分析中与骨水泥渗漏显著相关的变量，随后纳入多因素 logistic 回归分析，以确定骨水泥渗漏的独立危险因素。
单因素分析显示，动态骨折活动度（P<0.001）、手术入路（P=0.026）、周围椎体壁损伤（P<0.001）、椎体内裂隙（P<0.001）和注入的水泥量（P<0.001）与骨水泥渗漏相关。单因素分析有差异的因素进行多因素 logistic 回归分析，显示周围椎体壁损伤（OR=11.774，95%CI 4.384-31.619，P=0.000）、动态骨折活动度（OR=5.884，95%CI 2.295-15.087，P=0.000）、手术入路（OR=3.143，95%CI 1.136-8.698，P=0.027）和注入的水泥量（OR=1.486，95%CI 1.119-1.973，P=0.006）是术后骨水泥渗漏的独立危险因素。
本回顾性研究表明，动态骨折活动度、周围椎体壁损伤、手术入路和注入的水泥量是 PVP 和 PKP 后骨水泥渗漏的危险因素。
