Adjacent disc height reduction and clinical outcome after intradiscal cement leakage

Shen, Minjie; Niu, Junjie; Zhou, Haifei; Meng, Qingyu; Gan, Minfeng; Yang, Huilin

doi:10.14444/3034

Cited by 8 publications

(6 citation statements)

References 33 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to osteoporosis, excessive balloon distraction during surgery and multiple levels surgery, intradiscal leakage could be an independent risk factor for adjacent fractures. In the meantime, many studies revealed that bone cement may be toxic to the intervertebral disc and that it accelerates degeneration [49][50][51]. In our study, despite the higher intradiscal leakage rate, we did not observe a higher rate of adjacent segment fractures in the high-viscosity cement group.…”

Section: Discussioncontrasting

confidence: 69%

Assessment of Cement Leakage in Decompressed Percutaneous Kyphoplasty

Cheng,

Chou,

Tsuei

et al. 2024

JCM

View full text Add to dashboard Cite

Symptomatic osteoporotic compression fractures are commonly addressed through vertebroplasty and kyphoplasty. However, cement leakage poses a significant risk of neurological damage. We introduced “aspiration percutaneous kyphoplasty”, also known as “decompressed kyphoplasty”, as a method to mitigate cement leakage and conducted a comparative analysis with high viscosity cement vertebroplasty. We conducted a retrospective study that included 136 patients with single-level osteoporotic compression fractures. Among them, 70 patients underwent high viscosity cement vertebroplasty, while 66 patients received decompressed percutaneous kyphoplasty with low-viscosity cement. Comparison parameters included cement leakage rates, kyphotic angle alterations, and the occurrence of adjacent segment fractures. The overall cement leakage rate favored the decompressed kyphoplasty group (9.1% vs. 18.6%), although statistical significance was not achieved (p = 0.111). Nonetheless, the risk of intradiscal leakage significantly reduced in the decompressed kyphoplasty cohort (p = 0.011), which was particularly evident in cases lacking the preoperative cleft sign on X-rays. Kyphotic angle changes and the risk of adjacent segment collapse exhibited similar outcomes (p = 0.739 and 0.522, respectively). We concluded that decompressed kyphoplasty demonstrates efficacy in reducing intradiscal cement leakage, particularly benefiting patients without the preoperative cleft sign on X-rays by preventing intradiscal leakage.

show abstract

Section: Discussioncontrasting

confidence: 69%

Assessment of Cement Leakage in Decompressed Percutaneous Kyphoplasty

Cheng,

Chou,

Tsuei

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…They reported that at a mean follow-up of 20.56 months, intradiscal cement leakage was associated with a significant reduction in disc heights, without influencing clinical efficacy. 20 Our study also did not look at the risk factors for cement leakage during kyphoplasty. Ren et al studied the correlative factors for complications resulting from cement leakage in 71 patients who had kyphoplasty.…”

Section: Discussionmentioning

confidence: 93%

“…In addition, the clinical implications of the intervertebral disc degeneration were not evaluated. This issue has been examined in a recent study by Shen et al, 20 who compared 20 patients who had an intradiscal leak with 104 patients who did not. They reported that at a mean follow-up of 20.56 months, intradiscal cement leakage was associated with a significant reduction in disc heights, without influencing clinical efficacy.…”

Section: Discussionmentioning

confidence: 99%

Impact of the quantity of intradiscal cement leak on the progression of intervertebral disc degeneration

Jamjoom

Patel

Bommireddy

et al. 2017

annals

View full text Add to dashboard Cite

Introduction We aim to assess the impact of the quantity of intradiscal cement leak during kyphoplasty on the rate of progression of degenerative changes in the affected disc. Methods Of 316 kyphoplasty procedures, we identified 32 episodes of intradiscal cement leak in 26 patients. The quantity of cement leaked was graded from I to IV. Disc degenerative changes were assessed at presentation and follow-up using radiographical scoring and magnetic resonance imaging (MRI) grading systems. Data for low-grade leaks (grade I) were compared with the medium- and high-grade leaks (grades II-IV) using a chi-squared test. Results Median follow-up radiographic and MRI assessments were made at 18 and 21 months, respectively. Medium- and high-grade leaks were associated with a significantly higher radiographic disc degeneration scores compared with low-grade leaks (P = 0.04295) but no difference was found in MRI disc degeneration grades and in adjacent vertebral fracture rates. Conclusions Our findings indicate that the quantity of cement leaking into the disc space significantly influences the rate of progression of disc degeneration.

show abstract

“…On comparing pre- and post-operative intervertebral disc height differences between the experimental and control groups, all p-values were more than 0.05, indicating that PKP does not lead to significant changes in the height of the intervertebral discs. However, Shen M et al reported that intradiscal cement leakage can cause intervertebral disc degeneration [ 31 ]. Another study by Salamat S et al [ 21 ] reported that a Pfirrmann score of grade 5 is linked to significantly lower quantitative disc height scores.…”

Section: Discussionmentioning

confidence: 99%

Effect of Percutaneous Kyphoplasty on the progression of intervertebral disc degeneration: a retrospective cohort study

Han

Tian

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Background The effect of percutaneous kyphoplasty (PKP) or rather polymethylmethacrylate (PMMA) on adjacent intervertebral discs is still controversial. The evidence from experimental study to clinical study presents bipolar conclusions. In this study, we investigated the effect of PKP on adjacent intervertebral disc degeneration (IDD). Methods The experimental group included adjacent intervertebral discs of vertebrae treated with the PKP procedure, and the control group included adjacent intervertebral discs of non-traumatized vertebrae. All measurements were taken by magnetic resonance imaging or X-ray. The intervertebral disc height, the modified Pfirrmann grading system (MPGS), and its differences with Klezl Z and Patel S (ZK and SP) classifications were compared. Results A total of 264 intervertebral discs from 66 individuals were selected for the study. The comparison of intervertebral disc height between the two groups pre and post-operatively resulted in a p-value of > 0.05. No significant change was observed in the adjacent discs in the control groups post-operatively. Post-operatively, the mean Ridit increased significantly from 0.413 to 0.587 in the upper disc and from 0.404 to 0.595 in the lower disc in the experimental group. The comparison of MPGS differences showed that the predominant value was 0 in the Low-grade leaks group and 1 in the Medium and high-grade leaks group. Conclusions The PKP procedure can accelerate adjacent IDD, but it does not cause disc height changes in the early stage. The quantity of cement leaking into the disc space positively correlated with the rate of disc degeneration progression.

show abstract

Adjacent disc height reduction and clinical outcome after intradiscal cement leakage

Abstract: Intradiscal cement leakage was associated with the degeneration of cement-containing disc but did not reduce the clinical efficacy at early stages.

Cited by 8 publications

References 33 publications

Assessment of Cement Leakage in Decompressed Percutaneous Kyphoplasty

Assessment of Cement Leakage in Decompressed Percutaneous Kyphoplasty

Impact of the quantity of intradiscal cement leak on the progression of intervertebral disc degeneration

Effect of Percutaneous Kyphoplasty on the progression of intervertebral disc degeneration: a retrospective cohort study

Contact Info

Product

Resources

About