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2022, Vol. 26 ›› Issue (10): 1477-1482Analysis of the risk for bone cement leakage after percutaneous vertebroplasty in osteoporosis patients and model verificationLi Wenle1, 2, 3, Wang Haosheng4, Ning Lijun5, Zhang Wenshi6, Gao Sen7, Sun Lijun8, Hu Zhaohui3
Abstract: BACKGROUND: Cement leakage is the most common complication of percutaneous vertebroplasty, but the risk factors for cement leakage are still under debate. OBJECTIVE: To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty, establish and verify the prediction model. METHODS: Data of 385 patients with osteoporotic compression fractures that received percutaneous vertebroplasty in the Department of Spinal Surgery, Liuzhou People’s Hospital from June 2016 to June 2018 were retrospectively analyzed, including 77 males and 308 females. Age, sex, bone density, height, weight, body mass index, length of hospital stay, bone cement quantity, operation time, hospitalization to operation time, injury to operation time, whether more vertebral fractures, and steroid use in percutaneous vertebroplasty of postoperative bone cement leakage were analyzed using single factor and multiple factors analysis to identify the associated risk factors, and the forecast model was established and verified. This study was approved by the Institutional Review Committee of Liuzhou People’s Hospital. RESULTS AND CONCLUSION: (1) Bone cement leakage was observed in 81 of 385 patients. Single-factor Logistic regression analysis results showed that the injection amount of bone cement, operation duration and multiple vertebral fractures were correlated with bone cement leakage (P < 0.05). Multivariate Logistic regression analysis showed that higher bone cement injection volume [OR=1.283, 95%CI (1.004, 1.640), P < 0.05], longer operation time [OR=1.015, 95%CI (1.003, 1.027), P < 0.05] and multiple vertebral fractures [OR=2.456, 95%CI (1.461, 4.130), P < 0.05] patients had a greater risk of bone cement leakage. (2) The Nomogram was further established and validated. Results demonstrated that ROC=0.683, and the goodness of fit test result P=0.592, suggesting that the model has good predictive ability. (3) Results suggested that the injection amount of bone cement, operation time and multi-vertebral fracture were the risk factors for bone cement leakage after percutaneous vertebroplasty. Nomogram established can exactly predict the occurrence of bone cement leakage after percutaneous vertebroplasty. Key words:bone cement, osteoporotic, vertebral compression fracture, percutaneous vertebroplasty, bone cement leakage, risk factors, Nomogram |