Analysis of risk factors for cement leakage into the spinal canal in percutaneous vertebroplasty for spinal metastases
10.3760/cma.j.cn115396-20250104-00002
- VernacularTitle:经皮椎体成形术治疗脊柱转移瘤发生椎管内骨水泥渗漏的危险因素分析
- Author:
Feng JIN
1
;
Guoyu NI
;
Jinjun LI
;
Qi FEI
;
Hai MENG
Author Information
1. 首都医科大学附属北京友谊医院骨科，北京 100050
- Keywords:
Percutaneous vertebroplasty;
Thoracic vertebrae;
Lumbar vertebrae;
Spinal canal;
Risk factors
- From:
International Journal of Surgery
2025;52(10):700-706
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of cement leakage into the spinal canal in percutaneous vertebroplasty (PVP) for spinal metastases.Methods:A retrospective analysis was conducted on the case data of 211 patients with spinal metastases who underwent PVP in the Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University from January 2016 to June 2024. According to the presence or absence of intraspinal bone cement leakage after surgery, the patients were divided into the leakage group ( n=45) and the non-leakage group ( n=166). The clinical data of the two groups, including gender, age, bone mineral density T-score, American Society of Anesthesiologists (ASA) classification, operation time, and bone cement injection volume, were collected and statistically analyzed. Measurement data were expressed as mean±standard deviation ( ± s), and the independent samples t-test was used for comparison between groups; count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Univariate analysis was used to explore the possible risk factors for intraspinal bone cement leakage after PVP, and then the indicators with statistically significant differences in the univariate analysis were included in the multivariate Logistic regression analysis to identify the independent risk factors. Results:A total of 45 patients out of 211 patients with PVP surgery had cement leakage into the spinal canal after surgery, with an incidence rate of 21.3%. There were statistically significant differences between the leakage group and the non-leakage group in terms of whether the posterior wall of the vertebral body was broken, operation time, the injection volume of bone cement, distribution of injured vertebrae, and viscosity of bone cement ( P<0.05). The results of multivariate Logistic regression analysis showed that the broken posterior wall of the vertebral body, large injection volume of bone cement, and low viscosity of bone cement were the independent risk factors for the occurrence of cement leakage into the spinal canal in PVP for spinal metastases ( P<0.05). Conclusion:When PVP surgery is used to treat spinal metastases, broken posterior wall of the vertebral body, large injection volume of bone cement, and low viscosity of bone cement can increase the incidence of postoperative intravertebral cement leakage, and the operation should be performed with caution.
