The classification and its clinical value for extravertebral cement leakage complicated by percutaneous vertebral augmentation

Abstract

To explore the category and its clinical value of extravertebral cement leakage complicated by percutaneous vertebroplasty and kyphoplasty. After collecting clinical data of 56 patients underwent surgery of PVP or PKP between August 2001 and March 2005, extravertebral cement leakage was classified according to anatomical position, and its clinical value was analysed. Eighteen vertebraes presented cement leakage in all 43 vertebraes in PVP group. There were 15 vertebraes with one-place leakage, 6 vertebraes with perivertebral leakage, 5 spinal canal leakage, 2 intraforaminal leakage, 1 intradical leakage and 1 paravertebral soft tissues leakage respectively among them; and there were 3 vertebraes with two-place leakage. Four vertebraes presented cement leakage in all 22 vertebraes in PKP group. All 4 vertebraes had one-place leakage including 2 vertebraes with perivertebral leakage, 1 spinal canal leakage and 1 intraforaminal leakage. Five patients with cement leakage presented new symptoms including peritoneal irritation signs and spinal cord or nerve root injury, 3 patients recovered after conservative treatment, whereas the other 2 patients need decompression surgery. The types of perivertebral leakage and spinal canal leakage are common among extravertebral cement leakage followed by percutaneous vertebroplasty and kyphoplasty. The minority of patients with cement leakage presents new symptoms, and the majority of them has the same therapeutic effect except patients with spinal canal leakage on one day after surgery.