Abstract: BACKGROUND: Studies have shown that the endplate injuries in patients with osteoporotic vertebral compression fracture are related to the intradiscal cement leakage after percutaneous vertebral augmentation.
OBJECTIVE: To investigate the correlation between preoperative magnetic resonance imaging findings and intradiscal cement leakage after percutaneous vertebral augmentation, and to analyze whether endplate fractures and adjacent intervertebral disc injuries affect the incidence of intradiscal cement leakage. 
METHODS: Totally 182 patients with single-level osteoporotic vertebral compression fractures admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to December 2019 were selected, of which 110 received percutaneous kyphoplasty treatment, 72 cases received percutaneous vertebroplasty treatment. According to the preoperative magnetic resonance imaging images, the condition of the adjacent intervertebral disc injury and endplate fracture of the fractured vertebral body was evaluated. According to whether there is intradiscal cement leakage after the operation, the patients were divided into a leakage group (n=32) and a non-leakage group (n=150). A univariate analysis was performed on the correlation between the patient’s age, gender, surgical spinal level, surgical method, endplate fracture, adjacent intervertebral disc injury and intradiscal cement leakage, and then a multivariate binary logistics regression model analysis was performed. The study was approved by the Medical Ethics Committee of the Affiliated Hospital of Xuzhou Medical University.
RESULTS AND CONCLUSION: (1) Of the 182 patients, 63 had endplate fractures and 98 had adjacent intervertebral disc injuries. In all patients, 32 cases of intradiscal cement leakage occurred after percutaneous vertebral augmentation; the leakage rate of the endplate fracture group was higher than that of the non-endplate fracture group (P < 0.05), and the leakage rate of the intervertebral disc injury group was higher than that of the non-intervertebral disc injury group (P < 0.05). (2) The results of univariate analysis showed that intradiscal cement leakage was related to surgical method (P < 0.05), which was not related to age, gender, and surgical spinal level (P > 0.05). (3) The binary logistics regression analysis showed that the endplate fracture was the independent risk factor for intradiscal cement leakage after percutaneous vertebral augmentation; adjacent intervertebral disc injury, age, gender, surgical method, and surgical spinal level were not the risk factors for intradiscal cement leakage. (4) Related analysis showed that there was a significant correlation between the endplate fracture and the intervertebral disc injury (r=0.47, P=0.000). (5) The results showed that the endplate fracture found in the preoperative magnetic resonance imaging was a risk factor for intradiscal cement leakage, and the intervertebral disc injury was not the influence factor of intradiscal cement leakage; the intervertebral disc injury was significantly related to the endplate fracture in osteoporotic vertebral compression fractures patients.

Key words: bone, material, bone cement, percutaneous vertebral augmentation, osteoporotic, vertebral compression fracture, bone cement leakage, endplate fracture, intervertebral disc injury