Journal of Musculoskeletal Trauma

Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?: Hoon Sang Sohn, Seong Kee Shin, Eun Seok Seo, Kang Seob Chang; J Korean Fract Soc 2011;24(4):361-366. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.361

Abstract PDF: PURPOSE
This study aims to investigate the relationship between cement leakage into the disc during percutaneous balloon kyphoplasty and subsequent compression fractures in adjacent vertebrae during treatment of osteoporotic vertebral compression fracture.
MATERIALS AND METHODS
103 patients (118 vertebrae) who have been treated with balloon kyphoplasty due to osteoporotic compression fracture from June 2007 to July 2010 were retrospectively analyzed. The group was composed of 13 males and 90 females. The mean age was 75 years (57~95 years). The mean follow-up period was 10 months (6~30 months). Patients were divided into two groups; one with cement leakage into the disc and the other without cement leakage into the disc. The study was performed to determine whether subsequent compression fractures in adjacent vertebrae were related to several factors.
RESULTS
The cement leakages into the disc occurred in 16 of 118 vertebrae. Of the 16 vertebrae with cement leakage into the disc, 5 (31%) had subsequent adjacent vertebral compression fractures; however, of the 102 vertebrae in which cement leakage did not occur, only 11 (11%) had subsequent adjacent vertebral compression fractures (p<0.05). Of the 16 vertebrae with cement leakage into the disc, subsequent adjacent vertebral compression fractures occurred 1 vertebrae of 10 vertebrae with definite trauma history. Out of the 6 vertebrae with cement leakage and no definite trauma history, 4 vertebrae (67%) had subsequent adjacent vertebral compression fractures (p<0.05).
CONCLUSION
The cement leakage into the disc significantly increases the incidence of subsequent adjacent vertebral compression fractures. Most of the subsequent fractures occurred in the early post-operative period. When cement leakage into the disc occurred in patients with no definite trauma history such as slip down, the incidence of subsequent adjacent vertebral compression fracture increased significantly.

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Fatal Hemothorax Following Percutaneous Vertebroplasty: A Case Report: Hee Gon Park, Joo Hong Lee; J Korean Fract Soc 2007;20(2):202-205. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.202

Abstract PDF: Overall, the percutaneous vertebroplasty has low complication rate. Nevertheless, severe complications can occur. The majority of these are related to cement leakage. The cement migration through perivertebral venous system can lead to fatal complication. We present a case of death by hemothorax due to cement leakage following percutaneous vertebroplasty with literature review.

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Comparison of Uniportal and Biportal Vertebroplasty in Bone Cement Distribution and Leakage: Jae Hyup Lee, Kang Sup Yoon, Seung Baik Kang, Hyunchul Jo, Sang Ki Lee, Bong Soon Chang, Choon Ki Lee, Ji Ho Lee; J Korean Fract Soc 2006;19(4):471-476. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.471

Abstract: PURPOSE
To evaluate the differences of radiological outcomes of uniportal and biportal vertebroplasty in the point of bone cement distribution and leakage.
MATERIALS AND METHODS
A retrospective study reviewing the period between May 2002 and January 2006 investigated 100 vertebrae which underwent vertebroplasty and followed for more than three months by uniportal approach (55 vertebrae, group 1) and biportal approach (45 vertebrae, group 2). The operative time, the amount of bone cement injected, anterior vertebral height restoration, kyphotic angle, bone cement distribution, and bone cement leakage were evaluated.
RESULTS
The amount of injected bone cement of group 1 (3.9 cc) was statistically smaller than that of group 2 (5.1 cc) (p=0.016). There were no significant differences in the operative time, anterior vertebral height restoration, kyphotic angle in both groups. The rate of bone cement distribution over 8 zones was significantly higher in group 2 than in group 1 (p=0.014). However, the rate of bone cement distribution over 7 zones and the rate of bone cement distributed on whole anterior vertebral body were not significantly different in both groups. The cement leakage was not also significantly different in both groups.
CONCLUSION
Although the amount of injected bone cement was smaller in uniportal vertebroplasty, the radiological results and cement leakage were similar to biportal vertebroplasty. These findings suggest that uniportal vertebroplasty can be the operative options in osteoporotic vertebral fracture.

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