Abstract:

BACKGROUND: Percutaneous vertebroplasty and percutaneous kyphoplasty are commonly used in minimally invasive spine surgery in recent years. However, with the clinical development, bone cement leakage that is the main complication of percutaneous vertebroplasty and percutaneous kyphoplasty is also increasingly found in clinical reports.
OBJECTIVE: To review the research progress in bone cement leakage during percutaneous vertebroplasty and percutaneous kyphoplasty.
METHODS: The articles (2000/2011) about classification, related risk factors, the influence on the body, prevention and cure related to bone cement leakage during percutaneous vertebroplasty and percutaneous kyphoplasty were retrieved by the first author in the PubMed and Wanfang databases.
RESULTS AND CONCLUSION: Percutaneous kyphoplasty has a lower rate of bone cement leakage compared with percutaneous vertebroplasty. A small dosage of bone cement injection can restore the stiffness of the compressed vertebral. For the lumbar vertebra, 4 to 6 mL bone cement is enough. The injection dose can be increased for the thoracic vertebrae. Surgeons need to grasp the opportunity of bone cement injection. When we inject the bone cement over 10 minutes after modulation, the leakage rate of bone cement is low. When the vertebral wall is incomplete, the cement leakage rate is increased in the percutaneous vertebroplasty and percutaneous kyphoplasty. The chance of pulmonary embolism caused by bone cement leakage during percutaneous vertebroplasty and percutaneous kyphoplasty is low. But if it happens, it could lead to serious consequences, and also has certain effects on the cardiovascular system. Therefore, we must grasp the operation indication strictly, and choose the right entry point and the puncture path. We should control the dosage of bone cement and the injection timing correctly by precise operation and high-quality intraoperative monitoring to minimize the risk of bone cement leakage.