Acta Anatomica Sinica

Acta Anatomica Sinica ›› 2023, Vol. 54 ›› Issue (6): 710-715.doi: 10.16098/j.issn.0529-1356.2023.06.013

• Anatomy • Previous Articles     Next Articles

Risk analysis of bone cement leakage after percutaneous puncture vertebroplasty for osteoporotic spinal compression fractures and construction of a predictive model with column line drawings

HAN Yi*  CAI Li  FENG Xiao   

  1. Orthopedics Department of Guangyuan Second People’s Hospital, Sichuan Guangyuan 628000,China
  • Received:2022-05-18 Revised:2022-10-28 Online:2023-12-06 Published:2023-12-06
  • Contact: Yi Han E-mail:han25yii@163.com

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Abstract:

Objective To analysis risk factor and to construct a line graph prediction model for bone cement leakage after percutaneous transluminal vertebroplasty treatment in patients with osteoporotic spinal compression fractures.   Methods A total of 236 patients with osteoporotic spinal compression fractures who came to our hospital from December 2019 to December 2021 were selected for the study, and they were divided into a leakage group (n=58) and a non-leakage group (n=178) according to whether bone cement leakage occurred after percutaneous transluminal vertebroplasty treatment. The clinical data were collected to analyze the factors associated with bone cement leakage; The work receiver operating characteristic(ROC) curves of the subjects were drawn to analyze the predictive value of each relevant factor on bone cement leakage; The Logistic multiple regression model was used to analyze the risk factors affecting bone cement leakage; The R language software 4.0 “rms” package was used to construct the prediction model of column line diagram.   Results The differences in age, bone density, degree of vertebral compression, vertebral endplate/posterior wall integrity, bone cement viscosity, and bone cement injection volume between patients in the leaky and non-leaky groups were statistically significant (P<0.05). The area under curve(AUCs) for age, bone density, and cement injection volume to predict cement leakage were 0.804, 0.825, and 0.803, respectively; The best cutoff values were 71 years, 0.67 g/cm2, and 4.4 ml, respectively. Age (>71 years), bone density (≤0.67 g/cm2), vertebral compression (severe), vertebral endplate/posterior wall integrity (no), cement viscosity (low viscosity), and bone cement injection volume (>4.4 ml) were independent risk factors for bone cement leakage. The column line graph model predicted a C-index of 0.802 (95% CI , 0.689-0.868) for cement leakage, with a threshold >0.19, and the column line graph model provided a net clinical benefit.  Conclusion Age, bone density, degree of vertebral compression, vertebral endplate/posterior wall integrity, cement viscosity, and cement injection volume are independent risk factors for cement leakage, and the column line graph prediction model constructed with these predictors is of clinical application.

Key words: Osteoporosis, Spine compression fracture, Bone cement leakage, Nomograph model, Percutaneous vertebroplasty, Human

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