Effect Of Gelatin Sponge In Reducing Bone Cement Leakage During PVP

OBJECTIVE: The application of gelatin sponges has been regarded as a emerging technique in reducing bone cement leakage during percutaneous vertebroplasty(PVP)operation.Here we aim at evaluating whether gelatin sponges were useful in proventing bone cement leakage and trying to find out if the curative of different types of gelatin sponges varies in reducing bone cement leakage,so as to provide reference for clinical practice.METHODS: A retrospective analysis was performed,which totally consisted of97patients(97 vertebral bodies)who had underwent PVP surgery for osteoporotic vertebral compression fracture)(OVCF)in the Department of Spine Surgery of Dali People’s Hospital from June 2018 to June 2020.According to the different injection ways of bone cement,the patients were divided into traditional bone cement injection group(group A),pre-filled rod GS injection group(group B)and pre-filled granular GS injection group(group C).Group A was the blank control group,and groups B and C were the observation group.Traditional bone cement injection group(group A): 37 patients consisting of 9 males and 28 females,aged 71.97±6.44 years,,The distribution ratio ofinjured-vertebra versusinjured-thoracolumbar vertebra was 18/19;The pre-filled rod GS injection group(group B): 31 patients consisting of 11 males and 20 females,with an average age of 71.16 ± 8.00 years,the distribution ratio of injured-vertebra versus injured-thoracolumbar vertebra was 17/14.Pre-filled granule GS injection group(group C): 29 patients consisting of 8 males and 21 females,whose meanage were72.72 ± 7.55 years,the distribution ratio of injured-vertebra versus injured-thoracolumbar vertebra was 13/16.Patients in groups B and C were followed up for 6-30 months.All three groups were given preoperative and postoperative education and anti-osteoporosis drug therapy.The three groups were compared in terms of gender,age,distribution of injured vertebrae,bone cement injection volume,Cobb Angle,VAS score and ODI score before and after surgery and at the last follow-up.The changes of each evaluation index,the leakage of bone cement and the treatment of the corresponding clinical symptoms were analyzed.RESULTS: In the traditional bone cement injection group(group A),the 4.81±0.70 ml bone cement was injected per person and the number of bone cement leakage cases was 17 cases,accounted for about 45.95%.Pre-filled rod GS injection group(group B): 5.13±0.72 m L bone cement was injected per person,bone cement leakage cases were 5 cases,accounted for about 16.13%.Pre-filled granular GS injection group(group C): 4.90±0.90 m L bone cement was injected per person,and the number of bone cement leakage cases was 6 cases,accounted for about 20.69%.There were no vital differences in gender,age,distribution of injured vertebrae and injection dosage of bone cement among the three groups(P > 0.05).Cobb Angle,VAS score and ODI score before and after surgery were all statistically significant,while there was no statistically significant difference between there groups at each time period.All patients had no fatal symptomaticcomplication.CONCLUSIONS:(1)Both types of GS metioned above can effectively reduce bone cement leakage;(2)This result revealed that to some extent GS,acting as a mechanical barrier,,could increase the viscosity of bone cement.