Is Intervertebral Cement Leakage a Risk Factor for New Adjacent Vertebral Collapse?

Abstract

<jats:p> This retrospective study evaluated the relationship between intervertebral cement leakage and new adjacent vertebral fracture and describes the different characteristics of cement leakage. </jats:p><jats:p> Increased risk of new adjacent vertebral fracture (NF) has been reported to be a complication of cement leakage in vertebroplasty. In our observation, an incidental intervertebral cement leakage may occur during vertebroplasty but is commonly asymptomatic. </jats:p><jats:p> The study focused on osteoporotic collapse patients who had percutaneous vertebroplasty (PV) between 2005 and 2007. We divided patients into leakage and non-leakage groups and compared the incidence of NF. Leakage characteristics were divided into three types: Type I intervertebral-extradiscal leakage, Type II intradiscal leakage and Type III combined leakage. Visual analog scale for pain and the Karnofsky Performance Status at 24 h, three months, six months and one year were compared between groups and types of leakages. Among 148 PVs (102 patients) there were 30 leakages (20.27%) and 21(14.19%) NFs. The incidence of NF did not significantly differ between leakage and non-leakage groups (P&lt;0.05). Type II was the most common type of leakage (15/30). Reduction of average pain and improvement of Karnofsky Performance Status score did not differ between groups (P&lt;0.05). Type II had decreased pain score &lt; type I and III at 24 h (P &lt; 0.01), three months and six months (P &lt; 0.1) but not at one year (P&lt;0.10). Type II also had decreased pain score &lt; non-leakage group only at 24 h (P&lt;0.05). </jats:p><jats:p> Intervertebral cement leakage is not an increased risk for NF, influenced outcomes of pain relief or improvement of physical function. Intradiscal leakage (Type II) is the most common characteristic of cement leakage and probably related to delayed pain relief. </jats:p>

Development and Validation of a Nomogram for New Vertebral Compression Fractures in Postmenopausal Female Patients Undergoing Percutaneous Kyphoplasty Surgery

“…However, bone cement is prone to leakage during the procedure, and detecting the leakage is challenging [34] . Churojana et al [35] found that cement leakage into the intervertebral disc did not increase the risk of NVCF. In contrast, a retrospective analysis conducted by Choi et al [36] in 2022 demonstrated that bone cement leakage was a risk factor for recurrent vertebral fractures during a one-year follow-up.…”

Development and validation of a nomogram for predicting new vertebral compression fractures after percutaneous kyphoplasty in postmenopausal patients

“…However, bone cement is prone to leakage during PKP and leakage detection is challenging [ 36 ]. Churojana et al [ 37 ] found that cement leakage into the intervertebral disc did not increase the risk of NVCF. In contrast, a retrospective analysis conducted by Choi et al [ 38 ] reported a strong correlation between bone cement leakage and recurrent vertebral fractures at 1-year follow-up, consistent with the results of our study.…”

Earlier Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture May Minimize the Subsequent Development of Adjacent Fractures: A Retrospective Study

“…On the basis of different inclusion criteria, studies have reported the risk of an adjacent fracture after PVP may increase with a lower BMD (6,(16)(17)(18), greater age (16,19), female gender, and cement leakage to disc (19,20), intervertebral vacuum (16), lower BMI (21), increased preoperative segmental kyphosis (22), greater anterior height restoration rate (18), the distribution of cement within the fracture (23) and a larger number of fractures (17,(23)(24)(25).…”