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HOME > J Musculoskelet Trauma > Volume 24(4); 2011 > Article
Original Article
Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?
Hoon-Sang Sohn, M.D., Seong-Kee Shin, M.D., Eun-Seok Seo, M.D., Kang-Seob Chang, M.D.
Journal of the Korean Fracture Society 2011;24(4):361-366.
DOI: https://doi.org/10.12671/jkfs.2011.24.4.361
Published online: October 30, 2011

Department of Orthopedic Surgery, National Medical Center, Seoul, Korea.

Address reprint requests to: Seong-Kee Shin, M.D. Department of Orthopedic Surgery, National Medical Center, 245, Euljiro, Jung-gu, Seoul 100-799, Korea. Tel: 82-2-2260-7195, Fax: 82-2-2278-9570, 1453man@hanmail.net
• Received: September 10, 2010   • Revised: February 24, 2011   • Accepted: August 23, 2011

Copyright © 2011 The Korean Fracture Society

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  • 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.
  • Key words: Compression fracture, Cement leakage, Subsequent fracture, Kyphoplasty
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Fig. 1
Distribution of the initial fractures by location.
jkfs-24-361-g001.jpg
Fig. 2
Distribution of subsequent fracture by time period.
jkfs-24-361-g002.jpg
Fig. 3
A 69 year-old woman with compression fracture of L1.
Plain radiograph (A), (B) shows L1 osteoporotic vertebral compression fracture.
Plain radiograph (C), (D) immediately after kyphoplasty of L1 shows cement leakage into T12-L1 intervertebral disc.
Plain radiograph (E) and (F) 6 months after kyphoplasty shows subsequent fracture in lower end-plate of T12.
jkfs-24-361-g003.jpg
Table 1
New adjacent fractures among patients undergoing balloon kyphoplasty in relationship to cement leakage into disc
jkfs-24-361-i001.jpg

*Analyzed using a χ2 test.

Table 2
Demographics data of whole patients
jkfs-24-361-i002.jpg
Table 3
Demographics data of patients with cement leakage into disc
jkfs-24-361-i003.jpg
Table 4
New adjacent fractures among patients with cement leakage into disc in relationship to trauma
jkfs-24-361-i004.jpg

*Analyzed using a χ2 test.

Figure & Data

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        Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?
        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
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      Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?
      Image Image Image
      Fig. 1 Distribution of the initial fractures by location.
      Fig. 2 Distribution of subsequent fracture by time period.
      Fig. 3 A 69 year-old woman with compression fracture of L1. Plain radiograph (A), (B) shows L1 osteoporotic vertebral compression fracture. Plain radiograph (C), (D) immediately after kyphoplasty of L1 shows cement leakage into T12-L1 intervertebral disc. Plain radiograph (E) and (F) 6 months after kyphoplasty shows subsequent fracture in lower end-plate of T12.

      Fig. 1

      Fig. 2

      Fig. 3

      Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?

      New adjacent fractures among patients undergoing balloon kyphoplasty in relationship to cement leakage into disc

      *Analyzed using a χ2 test.

      Demographics data of whole patients

      Demographics data of patients with cement leakage into disc

      New adjacent fractures among patients with cement leakage into disc in relationship to trauma

      *Analyzed using a χ2 test.
      Table 1 New adjacent fractures among patients undergoing balloon kyphoplasty in relationship to cement leakage into disc

      *Analyzed using a χ2 test.

      Table 2 Demographics data of whole patients

      Table 3 Demographics data of patients with cement leakage into disc

      Table 4 New adjacent fractures among patients with cement leakage into disc in relationship to trauma

      *Analyzed using a χ2 test.

      Table 1

      Table 2

      Table 3

      Table 4

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