title: Should we fear cement leakage during kyphoplasty in percutaneous traumatic spine surgery? A single experience with 76 consecutive cases.
abstract: OBJECTIVE
  Although kyphoplasty is widely used to repair osteoporotic and pathologic vertebral fractures, balloon kyphoplasty and vertebral body stenting are new treatment options in cases of traumatic spinal injury. To our knowledge, there are no literature data on the incidence of cement leakage whereas these two percutaneous techniques are commonly used to repair non-pathologic fractures. The aim of this study was to evaluate and compare the clinical characteristics and the incidence of cement leakage associated with balloon kyphoplasty and vertebral body stenting in the percutaneous treatment of traumatic spinal injury.
  
  
  METHODS
  A series of 76 consecutive kyphoplasties (50 with vertebral body stenting and 26 balloon kyphoplasties) were retrospectively reviewed. Preoperative and postoperative computed tomography scans were analyzed in order to detect cement leakage and grade it as minor, moderate or major.
  
  
  RESULTS
  The overall leakage rate was 50%. None of the leakages gave rise to clinical symptoms. Although balloon kyphoplasty and vertebral body stenting did not differ in terms of the leakage rate, the latter technique was associated with a lower leakage volume. The Magerl type, fracture level and use of concomitant osteosynthesis did not appear to significantly influence the leakage rate.
  
  
  CONCLUSIONS
  Vertebral body stenting can reduce the amount of cement leakage due to a better cohesion of the bone fragments after kyphosis correction and maintenance.
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France. Electronic address: cyrille.capel@neurochirurgie.fr.
authors.forename: C
authors.initials: C
authors.lastname: Capel
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Fichten
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: B
authors.initials: B
authors.lastname: Nicot
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Lefranc
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Toussaint
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Desenclos
authors.affiliation: Service de radiologie, CHU d'Amiens, Amiens, France.
authors.forename: H
authors.initials: H
authors.lastname: Deramond
authors.affiliation: Service de radiologie, CHU d'Amiens, Amiens, France.
authors.forename: D
authors.initials: D
authors.lastname: Le Gars
authors.affiliation: Service de neurochirurgie, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Peltier
mesh_terms: D000328:Adult; D001843:Bone Cements / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D058498:Kyphoplasty / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D015607:Stents
chemical_list: D001843:Bone Cements
keywords: Adverse effects; Bone cement; Ciment acrylique; Effets indésirables; Fracture vertébrale; Fuite de ciment; Kyphoplastie; Kyphoplasty; Leakage; Spinal fracture