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Z Orthop Unfall
DOI: 10.1055/a-2343-4100
Originalarbeit

Cement Leakage after Augmentation of Osteoporotic Vertebral Bodies

Article in several languages: deutsch | English
Mina Aziz
1   Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland (Ringgold ID: RIN37734)
,
Inga Kniep
1   Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland (Ringgold ID: RIN37734)
,
Benjamin Ondruschka
1   Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland (Ringgold ID: RIN37734)
,
Klaus Püschel
1   Institut für Rechtsmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland (Ringgold ID: RIN37734)
,
Christian Hessler
2   Orthopädie und Unfallchirurgie, Asklepios Klinik Birkenwerder, Birkenwerder, Deutschland (Ringgold ID: RIN72063)
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Abstract

Introduction

Cement leakage is the most common complication of vertebral cement augmentation. The present study investigated cement leakage rates in spinal cement augmentation procedures and identified potential risk factors for cement leakage.

Methodology

140 cases (258 vertebrae) in 131 consecutive patients and nine postmortem cases were evaluated. A total of 258 cement-augmented vertebrae were studied. The data for this were obtained from the hospital records of 131 patients who underwent such operations in 2 orthopaedic trauma surgery clinics in the FRG and from the examinations of 9 postmortem cases at the Institute of Forensic Medicine of the University Medical Centre Hamburg-Eppendorf.

Results

Cement leaks were identified in 64 of the 140 cases (45.7%). Local cement leaks were the most common type of leak, accounting for 73.4% of leaks (n = 47). Venous leaks were evaluated in 15 cases (23.4%) and pulmonary embolisations in 2 cases (3.1%). Within the group of retrospectively studied cases (n = 131), only one patient (0.8%) suffered a symptomatic cement leak. Cement augmentation of fractures to lumbar vertebrae and application of large doses of cement were identified as risk factors for cement leakage.

Conclusion

Both the data in the literature relevant to the topic and the results of this work demonstrate a high incidence of cement leakage after vertebral body augmentation procedures. Risk factors for cement leakage are described. Despite the low percentage of symptomatic cases, the possible factors influencing cement leakage should be considered and included in the surgical planning when planning and performing cement augmentations on vertebral bodies.

Keywords

vertebroplasty - spine surgery - bone cement


Publication History

Received: 28 September 2023

Accepted after revision: 07 June 2024

Article published online:
12 August 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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