Risk Factors Of Different Types Of Vertebral Cement Leakage In 273 Cases Were Analyzed

Objective:This study retrospectively analyzed the clinical and imaging data of215 patients with osteoporotic compression fracture(OVCF),explored the risk factors of bone cement leakage in vertebral body plasty,and discussed the methods to prevent bone cement leakage.Methods:The clinical data of 215 patients with fracture who underwent vertebroplasty for OVCF in the Spinal Surgery Department of China-Japan Friendship Hospital of Jilin University from May 2018 to October 2019 were selected.The imaging data of 273 vertebroplasty vertebra(46 of which were type C,11 of which were type B and 8 of which were type S according to Yeom classification)were obtained.According to postoperative imaging examination whether there was leakage,they were divided into leakage group and non-leakage group.The measures included gender,age,fracture site,degree of vertebral compression,Cobb Angle,endplate destruction,posterior wall destruction,number of vertebral bodies operated at the same time,surgical method,and puncture method.T test,X ~2 test and Logistic regression were used.To explore the risk factors affecting the overall and different types of bone cement leakage,and to explore the prevention methods of bone cement leakage.Results:Logistic regression analysis of risk factors for overall leakage showed that Cobb Angle,endplate damage,posterior wall damage and number of vertebra operated at the same time were correlated with bone cement leakage(P<0.05),while the degree of compression,surgical method and puncture method were not correlated with bone cement leakage(P<0.05).Logistic regression analysis of the risk factors of different types of leakage showed that the risk factors related to C-type leakage were end-plate damage,posterior wall damage and puncture method(P<0.05).The risk factor associated with B-type leakage was back wall failure(P<0.05).The correlative factor of S-type leakage was end-plate failure(P<0.05).Conclusion:The results of this study indicate that fracture endplate damage,posterior wall damage,Cobb Angle,and number of vertebrae operated at the same time are risk factors for bone cement leakage during vertebroplasty.End-plate damage,posterior wall damage and puncture method were the risk factors for C-type cement leakage.The damage of the back wall is the risk factor of B-type leakage.End-plate failure is a risk factor for S-type leakage.In view of the above factors,the imaging data of patients should be improved and carefully read before vertebroplasty to clarify the damaged condition of the injured vertebrae cortex.If there is damage,targeted measures should be taken to prevent the leakage of bone cement during the operation.