Risk factors for bone cement dislodgement following balloon kyphoplasty for osteoporotic vertebral compression fracture

Kai-Chieh Chang; Chih-Ta Huang; Cheng-Ta Hsieh; Chien-Min Chen; Chih-Ju Chang

doi:10.1016/j.neuchi.2024.101559

Risk factors for bone cement dislodgement following balloon kyphoplasty for osteoporotic vertebral compression fracture

Neurochirurgie. 2024 Apr 16;70(4):101559. doi: 10.1016/j.neuchi.2024.101559. Online ahead of print.

Authors

Kai-Chieh Chang¹, Chih-Ta Huang², Cheng-Ta Hsieh³, Chien-Min Chen⁴, Chih-Ju Chang⁵

Affiliations

¹ Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei City, Taiwan; Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, 110, Taiwan.
² Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei City, Taiwan; Department of Biomedical Engineering, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
³ Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei City, Taiwan; Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
⁴ Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan; Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan.
⁵ Division of Neurosurgery, Department of Surgery, Cathay General Hospital, Taipei City, Taiwan; Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Mechanical Engineering, National Central University, Taoyuan City, Taiwan. Electronic address: miklechang5639@gmail.com.

PMID: 38614310
DOI: 10.1016/j.neuchi.2024.101559

Abstract

Objective: The study aimed to determine the incidence and risk factors associated with bone cement dislodgement in patients with osteoporotic vertebral compression fracture following balloon kyphoplasty treatment.

Methods: A retrospective study was conducted on 203 patients who underwent kyphoplasty in 255 vertebral bodies between January 2017 and December 2021. The patients were categorized into two groups: the bone cement dislodgment group (n = 16) and the non-bone cement dislodgement group (n = 239). Various patient characteristics and radiologic parameters were evaluated. Statistical analysis involved the assessment of the background homogeneity of the group by using independent sample t tests, chi-square tests, and Fisher's exact. Univariate and multivariate logistic regression analyses were performed to explore the impact of background variables on cement dislodgement.

Results: The results revealed that split-type fracture (χ² = 31.706, p < 0.001), DISH (χ² = 18.827, p = 0.011), pedicle fracture (χ² = 22.246, p < 0.001), endplate deficit (χ² = 14.023, p < 0.001), posterior wall injury (χ² = 29.124, p < 0.001), and intervertebral vacuum cleft (χ² = 21.469, p < 0.001) were the factors that significantly differed between the two groups. The multivariate logistic regression analysis revealed posterior wall injury (OR = 12.983, p = 0.025) and intervertebral vacuum cleft (OR = 5.062, p = 0.024) to be independent risk factors.

Conclusion: The incidence of bone cement dislodgement in our study was 6.3%. This study underscores the importance of using preoperative radiologic parameters to predict the risk of bone cement dislodgement following balloon kyphoplasty.

Keywords: Balloon kyphoplasty; Bone cement dislodgment; Osteoporotic vertebral compression fracture.