The Optimal Infusion Ratio Of Bone Cement In Percutaneous Vertebroplasty

Objective:This study aimed to investigate the risk factors for the form of cement distribution patterns and explore the optimal infusion ratio(IR%)of bone cement for percutaneous vertebroplasty(PVP).Methods:A total of 160patients who sufferred from osteoporotic vertebral compression fractures and underwent PVP were included.Patients were assigned to 2 groups according to cement distribution patterns,pain scores,and cement leakage.Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)were used to assess pain severity and function recovery,respectively.Clinical and radiological parameters were evaluated to identify independent factors via multivariate logistic regression analysis.A receiver operating characteristic curve was used to analyze the diagnostic value of cement IR%,and obtain the cut-off value.Results:The VAS and ODI scores showed no significant differences between the compact(n=67)and incompact(n=93)filling groups,but compact group(22.4%)had higher rate of new fractures than incompact group(9.7%)(X~2=4.935,P=0.026).Compression rate and age were identified as independent risk factors affecting the form of cement distribution patterns.But the area under the ROC curve of compression rate was considered a better predictor of cement distribution than age(0.754 vs 0.624,P<0.05).The IR%was identified as a risk factor for pain relief or cement leakage.The cut-off value to reach a favorable outcome was 24.98%,and the cut-off value of IR%for leakage was 25.52%.Conclusion:Compact filling pattern could increase the chances of new fractures after PVP.The optimal IR%was 24.98%to reach a favorable outcome,and lower the risk rate of new fractures and cement leakage.