Risk factors for predicting cement leakage in percutaneous vertebroplasty for spinal metastases |
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| Institution: | 1. Maeda Orthopedic and Surgery Clinic, Japan;2. Department of Orthopedic Surgery, Okayama Saiseikai General Hospital, Japan;1. Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX, USA;2. Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA;3. Department of Orthopaedic Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA;1. Department of Orthopaedics, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klosterlausnitzer Straße 81, D-07607, Eisenberg, Germany;2. Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany;3. Department of Ophthalmology, Friedrich-Schiller-University of Jena, Am Klinikum 1, D-07747, Jena, Germany;4. Department of Orthopaedics and Trauma Surgery, Alfried Krupp Hospital, Campus Rüttenscheid, Essen, Germany;1. Department of Orthopedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, 279-0001, Japan;2. Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;3. Department of Applied Regenerative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan;5. Kawaguchikogyo General Hospital, Japan;6. Doai Memorial Hospital, Japan;7. Yokohama Minato Red Cross Hospital, Japan;8. Tama-Hokubu Medical Center, Japan;9. Nitobe Memorial Nakano General Hospital, Japan;10. Suwa Central Hospital, Japan;11. Nissan Tamagawa Hospital, Japan;12. National Hospital Organization Disaster Medical Center, Japan;13. Tsuchiura Kyodo General Hospital, Japan;14. Soka City Hospital, Japan;15. Tokyo Bay Urayasu Ichikawa Medical Center, Japan;p. Tokyo Medical and Dental University Hospital, Japan;q. Nerima General Hospital, Japan;r. Kyoundo Hospital, Japan;s. Dokkyo Medical University Saitama Medical Center, Japan;t. Tokyo-Kita Medical Center, Japan;1. Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan;2. Kawaguchikogyo General Hospital, 1-18-15 Aoki, Kawaguchi, Saitama 332-0031, Japan;3. Doai Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo 130-8587, Japan;4. National Hospital Organization Disaster Medical Center, 3256 Midori, Tachikawa, Tokyo 190-0014, Japan |
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| Abstract: | BackgroundThe study aimed to identify the risk factors of cement leakage following percutaneous vertebroplasty for spinal metastases.Methods230 consecutive patients with 530 vertebrae were retrospectively reviewed. Characteristics including age, primary cancer, location, pathological fracture, the integrity of the posterior wall, and the volume of bone cement were considered as potential risk factors. Cement leakage was evaluated by postoperative imaging examination and classified into three subtypes with different potential sequelae: spinal canal leakage, intravascular leakage around vertebrae, intradiscal and paravertebral leakage. Univariate and multivariate analyses were used to assess the risk factors.ResultsLeakage was detected in 185 vertebrae (34.9%), 18.3% for intradiscal and paravertebral, 13.2% for intravascular around vertebrae, and 7.0% for spinal canal. Multivariate analysis showed that incomplete posterior wall (P = 0.001) and breast cancer (P = 0.015) were strong predictive factors for spinal canal leakage, incomplete posterior wall (P = 0.024) was for intravascular leakage around vertebrae, thoracic (P = 0.010) and pathological fracture (P = 0.000) were for intradiscal and paravertebral leakage.ConclusionsOur findings suggest that cement leakage is common following percutaneous vertebroplasty for spinal metastases. The incomplete posterior wall is an unfavourable factor for intravascular leakage around vertebrae. Vertebrae with incomplete posterior wall and breast cancer metastases are more likely to develop spinal canal leakage. |
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