A Retrospective Study to Evaluate the Effect of Dynamic Fracture Mobility on Cement Leakage in Percutaneous Vertebroplasty and Percutaneous Kyphoplasty in 286 Patients with Osteoporotic Vertebral Compression Fractures.

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.