Risk Factors For Predicting And Evaluating Cement Leakage Following Percutaneous Vertebroplasty With Imaging

Objective To investigate the preoperative risk factors of bone cement leakage after the percutaneous vertebroplasty(PVP)of osteoporotic vertebral compression fracture(OVCFs).Methods A total of 319 patients(486 vertebral bodies)with osteoporosis compression fractures(OVCFs)treated by PVP from 2012 to 2016 in our hospital were assigned into two groups: control group in which the patients were not found cement leakage after PVP and observation group in which patients were suffered from cement leakage Based on whether there occurred cement leakage.Possible related factors including gender,age,intravertebral cleft,Schmorl's nodes,the number of preoperative vertebral fractures(including the treated vertebrals),anatomy location of injury vertebral,fracture severity,vertebral fracture morphology,linear body fracture extending to the Vertebral cortex and end-plate destruction were screened by single variate analysis,and then the factors which had statistical significance were investigated by Binary logistic regression analysis.Finally the patients were assigned into five groups: control group and group B?group C?group D and group S.The above data were further analyzed using the multivariate logistic regression analysis.Results Single variate analysis revealed that only gender and Schmorl's nodes hasn't significant statistical differences(P value was 0.812 and 0.576,respectively)on the incidence rate of leakage of bone cement.age(P < 0.001),intravertebral cleft(P = 0.010),the number of vertebral fractures(P < 0.001),anatomy location of injury vertebral(P = 0.028),fracture severity,(P =0.036),vertebral body fracture morphology(P = 0.001),linear body fracture extending to the Vertebral cortex(P < 0.001),and the end-plate destruction(P < 0.001)has significant statistical significance.Binary Logistic regression analysis showed that the end-plate destruction(P = 0.001),linear body fracture extending to the Vertebral cortex(P = 0.014),the number of vertebral fractures(P = 0.003)and vertebral fracture morphology(P = 0.017)had a significant statistical significance.Multivariate logistic regression analysis shows that linear body fracture extending to the Vertebral cortex was the independent risk factor of type-C(P = 0.001).The endplate injury and the number of preoperative vertebral fractures are the independent risk factors for type-D.Conclusion When the vertebral body exists linear body fracture extending to the Vertebral cortex;end-plate destruction and Collapse fractures or there are lots of fracture of vertebral body,the operators should take reasonable measures to prevent the occurrence of leakage.