title: Cement Leakage in Percutaneous Vertebral Augmentation for Osteoporotic Vertebral Compression Fractures: Analysis of Risk Factors.
abstract: METHODS
  The risk factors for cement leakage were retrospectively reviewed in 192 patients who underwent percutaneous vertebral augmentation (PVA).
  
  
  OBJECTIVE
  To discuss the factors related to the cement leakage in PVA procedure for the treatment of osteoporotic vertebral compression fractures.
  
  
  BACKGROUND
  PVA is widely applied for the treatment of osteoporotic vertebral fractures. Cement leakage is a major complication of this procedure. The risk factors for cement leakage were controversial.
  
  
  METHODS
  A retrospective review of 192 patients who underwent PVA was conducted. The following data were recorded: age, sex, bone density, number of fractured vertebrae before surgery, number of treated vertebrae, severity of the treated vertebrae, operative approach, volume of injected bone cement, preoperative vertebral compression ratio, preoperative local kyphosis angle, intraosseous clefts, preoperative vertebral cortical bone defect, and ratio and type of cement leakage. To study the correlation between each factor and cement leakage ratio, bivariate regression analysis was employed to perform univariate analysis, whereas multivariate linear regression analysis was employed to perform multivariate analysis.
  
  
  RESULTS
  The study included 192 patients (282 treated vertebrae), and cement leakage occurred in 100 vertebrae (35.46%). The vertebrae with preoperative cortical bone defects generally exhibited higher cement leakage ratio, and the leakage is typically type C. Vertebrae with intact cortical bones before the procedure tend to experience type S leakage. Univariate analysis showed that patient age, bone density, number of fractured vertebrae before surgery, and vertebral cortical bone were associated with cement leakage ratio (P<0.05). Multivariate analysis showed that the main factors influencing bone cement leakage are bone density and vertebral cortical bone defect, with standardized partial regression coefficients of -0.085 and 0.144, respectively.
  
  
  CONCLUSIONS
  High bone density and vertebral cortical bone defect are independent risk factors associated with bone cement leakage.
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Baiyun District, GuangZhou City, Guangdong Province, China.
authors.forename: Weixing
authors.initials: W
authors.lastname: Xie
authors.forename: Daxiang
authors.initials: D
authors.lastname: Jin
authors.forename: Hui
authors.initials: H
authors.lastname: Ma
authors.forename: Jinyong
authors.initials: J
authors.lastname: Ding
authors.forename: Jixi
authors.initials: J
authors.lastname: Xu
authors.forename: Shuncong
authors.initials: S
authors.lastname: Zhang
authors.forename: De
authors.initials: D
authors.lastname: Liang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects; D002484:Cementation / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D005260:Female; D050815:Fractures, Compression / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000601:surgery*; D013131:Spine / Q000601:surgery; D054854:Vertebroplasty / Q000009:adverse effects* / Q000379:methods
chemical_list: D001843:Bone Cements