High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion and leak
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(2020) 21:589
RESEARCH ARTICLE
Open Access
High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion and leakage of bone cement Meiyong Wang1,2 and Qunhua Jin3*
Abstract Background: Bone cement leakage causes severe complication following percutaneous vertebroplasty. This study probed the diffusion and leakage status of bone cement injected within diverged time duration, so as to find the optimal injection time for bone cement. Methods: A total of 70 patients with osteoporotic vertebral compression fractures with a symptom of low back pain, who underwent treatment at hospital were enrolled in this study. Patients were randomized into three groups: < 180 s, 180–300, and > 300 s of injection time duration from the beginning to the completion of the injection. The scenarios of vertebral bone cement leakage and diffusion were inspected using postoperative CT. Results: The diffusion coefficient was higher in group A than in group B whereas it was higher in group B than in group C, but without statistical significance among the three groups. The leakage rate was without statistical significance among the three groups. The injection time of bone cement was negatively correlated with the diffusion coefficient, at the correlation coefficient of − 0.253. Conclusions: The diffusion coefficient of high-viscosity bone cement is negatively correlated with the injection time, and the leakage rate of high-viscosity bone cement does not reduce with the prolongation of injection time. Keywords: Percutaneous vertebroplasty, Bone cement, leakage, osteoporosis, elderly, pain, diffusion
Background Osteoporosis is one of the most common diseases of the elderly, and it results in considerable pain and decreased quality of life if not treated appropriately [1].Leakage of bone cement into the spinal canal or cardiovascular system could generate severe complications, such as nerve compression or embolism, and even cause death [2–4]. High-viscosity bone cement was applied to reduce the leakage risk [4–7], with the advantage of optionally long injection time, allowing surgeons to determine whether the * Correspondence: [email protected] 3 General hospital of Ningxia Medical University, Yinchuan, China Full list of author information is available at the end of the article
injection would be continued before cement leakage takes place, thus prominently improving operative safety [8]. Injection timing of bone cement is the direct impact factor for leakage. Baroud et al. [5] proposed cement leakage ceased completely when cement was delivered after 10 min, with good viscosity, and not prone to leakage [9]. Surgeons prefer injecting cement earlier, which causes rapid diffusion and leakage, to avoid procedure failure; however, delayed injection could raise difficulty due to the setting of cement [10]. Therefore, a precise timing of bone cement injection is critical, which should avoid leakage while cement spread more uniformly. The cement fills more uniformly is an essential element in
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