Correlation between preoperative magnetic resonance imaging findings and bone cement leakage after percutaneous vertebral augmentation.

Abstract

BACKGROUND: Studies have shown that the endplate injuries in patients with osteoporotic vertebral compression fracture are related to the intradiscal cement leakage after percutaneous vertebral augmentation. OBJECTIVE: To investigate the correlation between preoperative magnetic resonance imaging findings and intradiscal cement leakage after percutaneous vertebral augmentation, and to analyze whether endplate fractures and adjacent intervertebral disc injuries affect the incidence of intradiscal cement leakage. METHODS: Totally 182 patients with single-level osteoporotic vertebral compression fractures admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to December 2019 were selected, of which 110 received percutaneous kyphoplasty treatment, 72 cases received percutaneous vertebroplasty treatment. According to the preoperative magnetic resonance imaging images, the condition of the adjacent intervertebral disc injury and endplate fracture of the fractured vertebral body was evaluated. According to whether there is intradiscal cement leakage after the operation, the patients were divided into a leakage group (n=32) and a non-leakage group (n=150). A univariate analysis was performed on the correlation between the patient’s age, gender, surgical spinal level, surgical method, endplate fracture, adjacent intervertebral disc injury and intradiscal cement leakage, and then a multivariate binary logistics regression model analysis was performed. The study was approved by the Medical Ethics Committee of the Affiliated Hospital of Xuzhou Medical University. RESULTS AND CONCLUSION: (1) Of the 182 patients, 63 had endplate fractures and 98 had adjacent intervertebral disc injuries. In all patients, 32 cases of intradiscal cement leakage occurred after percutaneous vertebral augmentation;the leakage rate of the endplate fracture group was higher than that of the non-endplate fracture group (P 0.05). (3) The binary logistics regression analysis showed that the endplate fracture was the independent risk factor for intradiscal cement leakage after percutaneous vertebral augmentation;adjacent intervertebral disc injury, age, gender, surgical method, and surgical spinal level were not the risk factors for intradiscal cement leakage. (4) Related analysis showed that there was a significant correlation between the endplate fracture and the intervertebral disc injury (r=0.47, P=0.000). (5) The results showed that the endplate fracture found in the preoperative magnetic resonance imaging was a risk factor for intradiscal cement leakage, and the intervertebral disc injury was not the influence factor of intradiscal cement leakage;the intervertebral disc injury was significantly related to the endplate fracture in osteoporotic vertebral compression fractures patients. (English) [ABSTRACT FROM AUTHOR] 背景：有研究表明，骨质疏松性椎体压缩骨折患者伴随的终板损伤与经皮椎体强化后骨水泥椎间盘渗漏有关。 目的：探讨经皮椎体强化后骨水泥椎间盘渗漏与术前MRI发现的相关性，分析终板骨折及邻近椎间盘损伤对骨水泥椎间盘渗漏的影响。 方法：选择2018年9月至2019年12月徐州医科大学附属医院收治的单节段骨质疏松性椎体压缩骨折患者182例，其中110例接受经皮椎体后 凸成形骨水泥注射治疗，72例接受经皮椎体成形骨水泥注射治疗。根据术前MRI片评估骨折椎体相邻椎间盘损伤和终板骨折情况。根据术 后是否出现椎间盘骨水泥渗漏分为渗漏组(n=32)和无渗漏组(n=150)，对患者年龄、性别、手术椎体部位、手术方式、终板骨折情况、相邻 椎间盘损伤情况与骨水泥椎间盘渗漏的相关性进行单因素分析，再进行多因素的二元logistics回归模型分析。研究经徐州医科大学附属医 院医学伦理委员会批准。 结果与结论：①182例患者中，术前63例存在终板骨折，98例存在邻近椎间盘损伤；所有患者中，32例椎体强化后发生骨水泥椎间盘渗 漏，终板骨折组的渗漏率高于无终板骨折组(P 0.05)；③二元logistics回归分析显示，终板骨折是强化后 发生骨水泥椎间盘渗漏的独立危险因素，邻近椎间盘损伤、年龄，性别，手术方式、手术椎体部位不是骨水泥椎间盘渗漏的危险因素；④ 相关分析显示，终板骨折与椎间盘损伤存在显著相关性(r=0.47，P=0.000)；⑤结果表明，术前MRI发现的终板骨折是骨水泥椎间盘渗漏的 危险因素，而椎间盘损伤并非骨水泥椎间盘渗漏的影响因素，椎间盘损伤与终板骨折在骨质疏松性椎体压缩骨折患者中存在明显相关性。 (Chinese) [ABSTRACT FROM AUTHOR] Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo zu zhi gong cheng yan jiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)