Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures.

BACKGROUND: Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL.

OBJECTIVES: To establish an effective and novel nomogram for ICL following PVP in patients with osteoporotic-related vertebral compression fractures (OVCFs).

STUDY DESIGN: This was a retrospective study approved by the Institutional Review Board of our institution.

SETTING: This study consists of patients from a large academic center.

METHODS: Patients with OVCFs who underwent their first PVP in our department between January 2007 and December 2013 were included in this study. All the potential risk factors of ICL after PVP were recorded. Univariate and multivariate analyses were used to identify the independent risk factors. The nomogram was then created based on the identified independent risk factors.

RESULTS: A total of 241 patients and 330 vertebrae were included. The mean age of the patients was 73.5 (SD 7.9) years old, and the mean number of treated vertebrae was 1.4 per person. ICL was observed in 93 (28.2%) of the treated vertebrae. Greater fracture severity (P = 0.016), cortical disruption of the endplate (P < 0.0001), absence of Kummell's disease (P = 0.010), and higher computed tomography (CT) values (P = 0.050) were the independent risk factors for ICL.

LIMITATIONS: The main limitation of this study is that it is a retrospective study.

CONCLUSION: Greater fracture severity, cortical disruption of the endplate, absence of Kummell's disease, and higher CT values are the independent risk factors for ICL. The novel nomogram gives an accurate prediction of ICL.