A mysterious risk factor for bone cement leakage into the spinal canal through the Batson vein during percutaneous kyphoplasty: a case control study

Autor:	Shuang Xu, Shuai Zhang, Jin Yang, Chao Hua Yang, Gao Ju Wang, Qing Wang
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	Male Percutaneous Batson vein lcsh:Diseases of the musculoskeletal system Posterior vertebral wall morphology Postoperative Complications 0302 clinical medicine Risk Factors Fractures Compression Kyphoplasty Orthopedics and Sports Medicine 030212 general & internal medicine Aged 80 and over Lumbar Vertebrae Bone Cements Three-dimensional CT Middle Aged Foreign Bodies Bone cement Treatment Outcome medicine.anatomical_structure Spinal Fractures Female Bone cement leakage Osteoporotic vertebral compression fracture Research Article musculoskeletal diseases medicine.medical_specialty Thoracic Vertebrae Veins 03 medical and health sciences Imaging Three-Dimensional Lumbar Rheumatology medicine Humans Spinal canal Aged Retrospective Studies Percutaneous kyphoplasty business.industry Case-control study Case-Control Studies Thoracic vertebrae Orthopedic surgery lcsh:RC925-935 Tomography X-Ray Computed business Complication Nuclear medicine Spinal Canal Osteoporotic Fractures 030217 neurology & neurosurgery
Zdroj:	BMC Musculoskeletal Disorders, Vol 20, Iss 1, Pp 1-8 (2019) BMC Musculoskeletal Disorders
ISSN:	1471-2474
Popis:	Background Percutaneous kyphoplasty (PKP) can effectively treat osteoporotic vertebral compression fractures (OVCFs). Although satisfactory clinical outcomes can be achieved, bone cement leakage remains a primary complication of PKP. Previous studies have found many high risk factors for bone cement leakage into the spinal canal; however, less attention to the posterior wall morphologies of different vertebral bodies may be one reason for the leakage. Here, we investigated the effect of posterior vertebral wall morphology in OVCF patients on bone cement leakage into the spinal canal during PKP. Methods Ninety-eight OVCF patients with plain computed tomography (CT) scans and three-dimensional (3D) reconstruction images from T6 to L5 were enrolled. 3D-CT and multiplanar reconstructions (MPR) were used to measure the concave posterior vertebral wall depth (PVWCD) and the corresponding midsagittal diameter of the nonfractured vertebral body (VBSD), and the PVWCD/VBSD ratio was calculated. All subjects were divided into the thoracic or lumbar groups based on the location of the measured vertebrae to observe the value and differences in the PVWCD between both groups. The differences in PVWCD and PVWCD/VBSD between the thoracic and lumbar groups were compared. Three hundred fifty-seven patients (548 vertebrae) who underwent PKP within the same period were also divided into the thoracic and lumbar groups. The maximal sagittal diameter (BCSD), the area of the bone cement intrusion into the spinal canal (BCA), and the spinal canal encroachment rate (BCA/SCA × 100%) were measured to investigate the effect of the thoracic and lumbar posterior vertebral wall morphologies on bone cement leakage into the spinal canal through the Batson vein during PKP. Results The PVWCDs gradually deepened from T6 to T12 (mean, 4.6 mm); however, the values gradually became shallower from L1 to L5 (mean, 0.6 mm). The PVWCD/VBSD ratio was approximately 16% from T6 to T12 and significantly less at 3% from L1 to L5 (P 2, and the BCA/SCA ratio was 17.2 ± 2.0%. In the lumbar group, the BCSD was 1.4 ± 0.3 mm, the BCA was 14.8 ± 2.2 mm2, and the BCA/SCA ratio was 7.4 ± 1.0%. The BCSD, BCA and BCA/SCA ratio were significantly higher in the thoracic group than in the lumbar group (P Conclusions The PVWCD in the middle and lower thoracic vertebrae can help reduce bone cement leakage into the spinal canal by enabling avoiding bone cement distribution over the posterior 1/6 of the vertebral body during PKP. The effect of the difference between the thoracic and lumbar posterior vertebral wall morphology on bone cement leakage into the spinal canal through the Batson vein in OVCF patients during PKP is one reason that the rate of bone cement leakage into the thoracic spinal canal is significantly higher than that into the lumbar spinal canal.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2eb3085496587be2b3fcba35cffcc70b http://link.springer.com/article/10.1186/s12891-019-2807-6 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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