The effect of bone-filled mesh bag technique on bone cement leakage in the treatment of osteoporotic vertebral compression fractures associated with intravertebral vacuum cleft
Objective:To investigate the effect of bone-filled mesh bag technique on bone cement leakage in the treatment of osteoporotic vertebral compression fractures(OVCFs)with intravertebral vacuum cleft(IVC)using percutaneous kyphoplasty(PKP).Methods:A retrospective analysis was conducted on OVCF patients who underwent PKP treatment from June 2021 to June 2022.Patients were diagnosed with IVC based on the preoperative imaging findings.According to the surgical records in the hospital information system,patients were divided into the simple PKP group and the bone-filled mesh bag PKP group.Postoperative bone cement leakage and leakage sites were assessed.Statistical analyses were performed on the postoperative pain visual analogue scale(VAS),Oswestry Disability Index(ODI),compressed vertebral height ratio,and local kyphotic angle(LKA).Results:A total of 91 OVCF patients with IVC were included,with 48 cases in the simple PKP group and 43 cases in the bone-filled mesh bag PKP group.The follow-up data showed cement leakage in 26 patients,with no severe complications such as neural injury,pulmonary embolism,myocardial infarction,or cerebral infarction.The leakage rate in the bone-filled mesh bag PKP group(11.63％)was significantly lower than that in the simple PKP group(43.75％)(P＜0.01).There were no statistically significant differences in VAS scores on postoperative day 1,6 months,or 12 months between the two groups(all P＞0.05).Postoperative day 1 and 6-month ODI showed no statistical differences between the two groups(both P＞0.05).However,at 12 months postoperatively,the ODI in the bone-filled mesh bag PKP group was significantly better than that in the simple PKP group(P＜0.01).On the first day after the operation,the compressed vertebral height ratio and the LKA between the two groups had no significant statistical difference(both P＞0.05),but at 6 and 12 months,the compressed vertebral height ratio and the LKA in the bone-filled mesh bag PKP group were better than those in the simple PKP group(all P＜0.05).Conclusions:The use of bone-filled mesh bag technique in PKP treatment for OVCF patients with IVC has a better preventive effect on the leakage of bone cement into the intervertebral space and paravertebral tissue.Additionally,it plays a certain preventive role in the loss of vertebral height and LKA of the injured vertebrae after surgery.
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