The Reasons And Analysis Of Unsatisfied Bone Cement Distribution In Percutaneous Vertebroplasty And Percutaneous Vertebral Kyphoplasty

Objective: Retrospective analysis the reasons and relative treatment ofunsatisfied bone cement distribution in PVP/PKP.Methods:13cases which the bone cement distribution were notsatisfied during PVP/PKP surgery from December2009to April2013inthe Second Affiliated Hospital of Chongqing Medical University. All the13patients got PVP or PKP due to osteoporotic vertebral compression fractures.2cases got secondary PVP because the unsatisfied pain relief after gettingPKP and unsatisfied distribution of bone cement showed in their CT scan.The remaining11cases got immediate treatment with the reason ofunsatisfied distribution of bone cement after initial bone cement injectionwith the help of C-armed fluoroscopy. The data of preoperative andpostoperative VAS score, preoperative vertebral CT scan and postoperativebone cement distribution in relevant vertebral were collected.Results: The CT scan showed transverse compact zone existed in2 patients whose pain were not satisfy relieved. After got the second PVP, the2patients got pain relief immediately. For the2patients, the preoperativeVAS score was8.35, first postoperative VAS score was7.60and the secondpostoperative VAS score was2.90. Their X-films and CT scan showed goodbone cement distribution after the second surgery. The remaining11patientsgot obvious pain relief after the surgery. For their preoperative and3daysafter the surgery VAS score were7.95±0.54and2.63±0.5, respectively. Thepreoperative vertebral CT scan showed transverse compact zone in all the11cases, and their postoperative CT scan showed good bone cementdistribution in diseased vertebral.Conclusion: Percutaneous vertebroplasty and percutaneousvertebroplasty angioplasty are safe and effective surgical methods. In PVP/PKP surgery, unsatisfied bone cement distribution may lead to bad painrelief. Unsatisfied bone cement distribution may have some something to dowith transverse compact zone. Bone cement distribution may be one factorinfluencing the pain-killing effect. For the incomplete distribution of bonecement cases, we can adjust the bone cement channel or adopt secondaryPVP treatment to improve bone cement distribution, so as to achieve thepurpose of pain relief.