Measures to reduce the leakage rate of bone cement during vertebral augmentation
Yang Liu1, Du Jianwei2
1Dalian Medical University, Dalian 116041, Liaoning Province, China; 2Affiliated Hospital of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
Abstract: BACKGROUND: At present, vertebral augmentation has become the prior choice for the treatment of osteoporotic vertebral compression fractures. How to reduce the leakage rate of intraoperative bone cement has attracted the attention of clinical workers.
OBJECTIVE: To review the current clinical research on reducing the leakage rate of bone cement in terms of surgical methods and bone cement factors.
METHODS: PubMed, Wanfang, and CNKI databases were searched for articles about bone cement leakage during vertebral augmentation published from 1987 to 2021 with the key words of “cement leakage, vertebral augmentation, osteoporotic vertebral compression fractures” in Chinese and English. The articles which were irrelevant and repetitive were excluded, and 43 articles were reserved for review.
RESULTS AND CONCLUSION: Vertebral augmentation surgery has various surgical methods. Percutaneous vertebroplasty and kyphoplasty are the two most common methods. Kyphoplasty can reduce the leakage rate of bone cement. The factors of bone cement itself, such as the type of bone cement, viscosity and injection volume, can also affect the leakage rate of bone cement. The clinical consequence of bone cement leakage is related to the type of leakage, and the most common is paravertebral leakage; and the most serious complication is intraspinal leakage. With the deepening of research, clinical workers have innovated many technologies to deal with bone cement leakage, but the effect is not obvious. Robot assisted vertebroplasty is a technology worthy of clinical practice. It is believed that with the continuous update and development of technology, the problem of bone cement leakage will be effectively solved.
Key words: vertebral augmentation, osteoporosis, vertebral compression fracture, percutaneous vertebroplasty, kyphoplasty