The complications and prevention of percutaneous vertebral kyphoplasty for the treatment of the thoracic and lumbar osteoporotic compression fractures during the operation
10.3760/cma.j.issn.1674-6090.2013.03.014
- VernacularTitle:经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折的并发症及预防
- Author:
Xisan WANG
;
He LIU
;
Guangxun HU
;
Wu LUO
;
Li LI
;
Yongqin FANG
;
Huiying MAI
- Publication Type:Journal Article
- Keywords:
Percutaneous vertebral kyphoplasty;
Osteoporotic;
Thoracolumbar compression fractures;
Complication;
Prevention
- From:Journal of Endocrine Surgery
2013;7(3):226-230
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the complications of percutaneous kyphoplasty (PKP) in treatment of osteoporotic compression fractures (OVCFs) of the thoracic and lumbar vertebrae,and to investigate their causes and prevention.Methods From Jan.2004 to Dec.2012,PKP or PKP combined with percutaneous vertebroplasty(PVP) was performed on 126 vertebrae in 112 thoracolumbar OVCFs patients.There were 21 males and 91 females.The average age was 69 years (ranging from 36 to 85).100 cases had single vertebra,10 cases had double vertebrae,and 2 cases had 3 vertebrae.The injured segments were identified by MRI before surgery,and the fractures of the vertebrae were observed clearly by X ray and CT scan.The causes of the complications were retrospective analyzed.Results Perioperative complication happened in 68 cases (54％).The leakage of the bone cement happened in 66 cases (52.4％):one of them had high fever after the leakage happened behind the post-wall of the vertebra body,and it disappeared after one week with the relevant treatment.There was no injury of the nerve.Most of the leakage happened in front of the vertebra body,few happened in the terminal plate,and few happened behind the vertebral plate.There was no pulmonary embolism.Toxic reaction of the bone cement wasn't found in this team.There was no artery or nerve injury.One temporary spinal cord injury happened,one case was punctured in a wrong vertebra,and balloon rupture happened in one case.One case didn't achieve pain release.No infection happened.Conclusion The bone cement leakage was the most common complication associated with PKP in treatment of OVCFs.The complication rate can be reduced if the operation indications are strict,the volume of the filling cementis is well controlled,and the operation is performed in experienced hands.
