Relationship between bone cement leakage and vascular anatomy of the thoracolumbar vertebral body:  a retrospective analysis of 105 cases

doi:10.3969/j.issn.2095-4344.0652

Abstract

Abstract:

BACKGROUND: Previous studies have shown that bone cement leakage rate is mainly associated with surgical procedure of kyphoplasty and vertebral venous reflux.

OBJECTIVE: To analyze the relationship between bone cement leakage rate and surgical procedure of vertebral kyphoplasty based on the distribution rule of thoracolumbar vessels.

METHODS: Clinical data of 105 patients treated with vertebral kyphoplasty for osteoporotic vertebral compression fractures (OVCFs) 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). Then, the patients were divide into three groups according to the injection site of bone cement: the left side of safety zone (group 1), safety zone (group 2) and the right side of safety zone (group 3). Bone cement leakage rate, the amount of bone cement injected, the recovery rate of vertebral height and the recovery of Cobb angle and the improvement of pain were observed in each group.

RESULTS AND CONCLUSION: (1) The total rate of bone cement leakage and the rate of leakage via the vertebral vein in the group A were lower than those in the groups B and C (P < 0.05), and the amount of bone cement injected was higher than that in the groups B and C (P < 0.05). On the second day after surgery, there was no significant difference between the three groups in the recovery rate of vertebral height, the recovery of Cobb angle and visual analogue scale score. (2) The total rate of bone cement leakage and the rate of leakage via the vertebral vein in the group 2 were lower than those in the groups 1 and 3 (P < 0.05), and the amount of bone cement injected was higher than that in the groups B and C (P < 0.05). On the second day after surgery, there was no significant difference between the three groups in the recovery rate of vertebral height, the recovery of Cobb angle and visual analogue scale score. Overall, the results from this study confirm the existence of “safety zone” in the vertebra and indicate that management of puncture angel and injection site of bone cement can potentially reduce the cement leakage rate.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Osteoporotic Fractures, Vertebroplasty, Intraoperative Complications, Surgical Procedures, Minimally Invasive, Tissue Engineering

CLC Number:

R318

Zhang Yang, Gong Weiming, Song Hongliang, Zhong Jiangbo, Jia Tanghong. Relationship between bone cement leakage and vascular anatomy of the thoracolumbar vertebral body: a retrospective analysis of 105 cases[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(34): 5426-5432.

Figures/Tables 9

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