Cement Leakage in Percutaneous Vertebral Augmentation for Osteoporotic Vertebral Compression Fractures

Xie, Weixing; Jin, Daxiang; Ma, Hui; Ding, Jinyong; Xu, Jiamin; Zhang, Shuncong; Liang, De

doi:10.1097/bsd.0000000000000229

Cited by 31 publications

(29 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study demonstrated that a higher CT value is an independent risk factor for ICL. Xie et al (28) found that patients with higher degree of osteoporosis had a lower chance of ICL. Bone mineral density (BMD) mea- www.painphysicianjournal.com sured by dual energy x-ray absorptiometry is a standard measurement for osteoporosis (34).…”

Section: Discussionmentioning

confidence: 99%

“…Higher vertebral body CT values indicate a greater degree of trabecular bone per unit area and smaller spaces between the trabecular. As such, assuming the same dispersion rate and volume of PMMA, the smaller intertrabecular spaces would then require a greater area of cement spread (compared to an osteoporotic patient having larger intertrabecular spaces), thus increasing the risk of ICL (28). Another frequently debated risk factor is injected cement volume.…”

Section: Discussionmentioning

confidence: 99%

“…Pain with this leakage can reduce the quality of patients' lives (22)(23)(24)(25)(26). The risk factors for ICL are still under debate (19,(27)(28)(29). To date, there has been no effective nomogram to predict the risk of ICL.…”

Section: Radiographic Evaluation and Data Collectionmentioning

confidence: 99%

See 2 more Smart Citations

Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures

Zhong

Zhu

et al. 2017

Pain Phys

View full text Add to dashboard Cite

Background: Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL. Objectives: To establish an effective and novel nomogram for ICL following PVP in patients with osteoporotic-related vertebral compression fractures (OVCFs). Study Design: This was a retrospective study approved by the Institutional Review Board of our institution. Setting: This study consists of patients from a large academic center. Methods: Patients with OVCFs who underwent their first PVP in our department between January 2007 and December 2013 were included in this study. All the potential risk factors of ICL after PVP were recorded. Univariate and multivariate analyses were used to identify the independent risk factors. The nomogram was then created based on the identified independent risk factors. Results: A total of 241 patients and 330 vertebrae were included. The mean age of the patients was 73.5 (SD 7.9) years old, and the mean number of treated vertebrae was 1.4 per person. ICL was observed in 93 (28.2%) of the treated vertebrae. Greater fracture severity (P = 0.016), cortical disruption of the endplate (P < 0.0001), absence of Kummell’s disease (P = 0.010), and higher computed tomography (CT) values (P = 0.050) were the independent risk factors for ICL. Limitations: The main limitation of this study is that it is a retrospective study. Conclusion: Greater fracture severity, cortical disruption of the endplate, absence of Kummell’s disease, and higher CT values are the independent risk factors for ICL. The novel nomogram gives an accurate prediction of ICL. Key words: Osteoporotic vertebral compression fracture, percutaneous vertebroplasty, intradiscal cement leakage, risk factors, prediction, nomogram

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures

Zhong

Zhu

et al. 2017

Pain Phys

View full text Add to dashboard Cite

show abstract

“…Marc et al [33] believed that fracture severity and cement viscosity were risk factors for cement leakage. Xie Weixing et al [34] proposed that high bone density and cortical bone defect were independent risk factors of cement leakage. According to Ding Jie et al [35], the leakage of bone cement is related to the severity of fracture, the defect of endplate and the viscosity of bone cement.…”

Section: Discussionmentioning

confidence: 99%

Comparison of early results of Vesselplasty and percutaneous vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fracture

Mei¹,

Wu²,

Song³

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective To investigate the early clinical effect of vesselplasty and percutaneous vertebroplasty in the treatment of elderly patients osteoporotic vertebral compression fractures. MethodsA retrospective analysis was performed on 22 patients (10 males and 12 females, aged 60~85 years old （73.1±9.6）with osteoporosis fracture treated by vesselplasty in Shanxi Bethune Hospital from March 2017 to December 2018..During the same period, 56 patients (20 males and 36 females, aged 60-80 years (70.3±9.4) were treated with percutaneous vertebroplasty (PVP) for osteoporosis fractures.Preoperative and postoperative Visual Analogue Score (VAS), operative time, intraoperative bone cement leakage, preoperative and postoperative vertebral body anterior margin height were recorded to evaluate the clinical efficacy.ResultsIn the vesselplasty group, preoperative VAS score was 7.9±0.9, postoperative VAS score was 3.8±0.8, postoperative recovery rate of vertebral height was 19.9%±19.1%, operative time (33.6±6.2)min, and bone cement leakage was observed in 3 cases.In the PVP group,preoperative VAS score was 7.9±0.9, postoperative VAS score was 3.7±0.8, postoperative recovery rate of vertebral height was 18.8%±18.2%, operative time (35.8±6.6)min, and bone cement leakage was observed in 15 cases.Compared with the PVP group（26.8%, the bone cement leakage rate of the vesselplasty group （13.6%）was significantly reduced, and the difference was statistically significant, but there was no significant difference in other data. ConclusionBoth vesselplasty and percutaneous vertebroplasty can achieve satisfactory early clinical efficacy in the treatment of senile osteoporosis vertebral compression fractures. Bone cement leakage rate of vesselplasty is smaller and it is safer.

show abstract

“…Von der Vertebroplastie und Kyphoplastie wissen wir, dass es zwischen 15 und 60 % zu Zementparavasaten kommen kann [4][5][6]. Wir selber haben bei einer konventionellen postoperativen Kontrolle nach 1167 Patienten mit Kyphoplastie eine asymptomatische Rate an Paravasaten von 17 % festgestellt [6].…”

Section: Discussionunclassified

Venöse Paravasate nach Augmentation von Pedikelschrauben – ein unterschätztes Risiko

et al. 2017

View full text Add to dashboard Cite

ZusammenfassungMit zementaugmentierten Pedikelschrauben kann die Festigkeit von Fixateuren bei instabilen Wirbelfrakturen im Alter erhöht werden. Die Fixateure können minimalinvasiv und schnell eingebracht werden und verringern das Operationsrisiko. Wir haben von März 2012 bis Juli 2014 40 Patienten mit instabilen Wirbelfrakturen mit einem perkutanen augmentierten Fixateur versorgt. Das Durchschnittsalter betrug 77,5 Jahre. Kein Patient verstarb im Beobachtungszeitraum von 6 Monaten. Neurologische Ausfälle traten nicht auf. Die Schmerzen konnten von im Mittel 8,5 Punkten auf der VAS auf 4,1 Punkte postoperativ gesenkt werden. Durch die Operation konnte der Cobb-Winkel im Mittel um 4,1° verbessert werden. Nach 6 Monaten kam es nur zu einer Sinterung von 1° bis max. 4°, im Mittel 2,6°. Häufig kam es aber zu venösen Paravasaten durch Zementabflüsse aus den augmentierten Wirbeln bis hin zur Lungenembolie. Meist bleiben diese Embolien asymptomatisch. Wir berichten über einen Patienten, der unmittelbar nach der Zementapplikation aufgrund von Lungenembolien reanimationspflichtig wurde. Der Patient überlebte aufgrund der sofort durchgeführten intensivmedizinischen Maßnahmen. Das Risiko ist in der Literatur wenig bekannt und bislang unterschätzt trotz steigender Operationszahlen mit augmentierten Fixateuren. Eine Reduzierung des Risikos ist durch langsame Zementinjektion, kleinere Zementapplikatoren und kurzfristiger Überdruckbeatmung mit PEEP (positive expiratory pressure) möglich.

show abstract

Cement Leakage in Percutaneous Vertebral Augmentation for Osteoporotic Vertebral Compression Fractures

Abstract: High bone density and vertebral cortical bone defect are independent risk factors associated with bone cement leakage.

Cited by 31 publications

References 12 publications

Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures

Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures

Comparison of early results of Vesselplasty and percutaneous vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fracture

Venöse Paravasate nach Augmentation von Pedikelschrauben – ein unterschätztes Risiko

Contact Info

Product

Resources

About