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| ZHU Haifeng,ZHUO Hang,DAI Jiahui.Correlation between preoperative MRI imaging indicators and cement leakage after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures[J].Chinese Journal of Spine and Spinal Cord,2026,(4):451-459. |
| Correlation between preoperative MRI imaging indicators and cement leakage after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures |
| Received:September 16, 2025 Revised:March 15, 2026 |
| English Keywords:Osteoporotic lumbar vertebral compression fracture Percutaneous vertebroplasty Cement leakage Basivertebral foramen MRI |
| Fund:国家自然科学基金项目（82305264）；基础与应用基础研究专题（青年博士“启航”项目 2024A04J4331）；广东省中管局项目（20251107）；广州中医药大学第一附属医院中青年骨干人才培育项目-青优人才（2023QY13） |
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| English Abstract: |
| 【Abstract】 Objectives: To explore the correlation between preoperative MRI-measured imaging parameters and cement leakage(CL) after percutaneous vertebroplasty(PVP) for osteoporotic lumbar vertebral compression fracture(OLVCF). Methods: A total of 84 patients with OLVCF who underwent PVP in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2020 to December 2023 were retrospectively analyzed. Based on bone cement leakage or not according to lumbar X-ray and CT reexamination at postoperative 3d, the patients were divided into a leakage group and a non-leakage group. The leakage group was further subdivided into basivertebral foramen leakage(type B) and segmental venous leakage(type S). General data of the patients were collected, including age, sex, BMI, bone mineral density T-score, injured vertebral level, and bone cement volume. Preoperative MRI parameters including the vertebral bone quality(VBQ), basivertebral foramen height(BFH), and basivertebral foramen depth(BFD) of the injured vertebra were measured and recorded, along with the volume of bone cement injected during surgery. Intergroup comparisons were performed using t-tests, ANOVA, and chi-square tests. Logistic regression was employed to analyze factors influencing CL, a mediation model was used to examine the mediating effect of cement volume, and ROC curves were plotted to evaluate predictive performance. Results: The OLVCF patients enrolled aged 75.8±8.1 years(60-90 years). There were 53 cases in the leakage group(33 cases of type B and 20 cases of type S), and 31 cases in the non-leakage group. Baseline comparisons showed no significant differences in age, BMI, gender, bone mineral density T-score, injured vertebral level, cement volume, VBQ score, BFD, or fracture severity between the leakage and non-leakage groups or between type B and type S subgroups and the non-leakage group(P>0.05), except BFH(P<0.05). Binary logistic regression indicated in the leakage group and non-leakage group that the cement volume was a protective factor for CL(OR=0.677, 95%CI: 0.514-0.892, P=0.006), while BFH was an independent risk factor(OR=1.740, 95%CI: 1.303-2.324, P<0.001). Multinomial logistic regression for subgroup analysis, using the non-leakage group as reference, showed that BFH was a common independent risk factor for both type B(OR=1.906, 95%CI:1.387-2.619, P<0.001) and type S leakage(OR=1.550, 95%CI: 1.128-2.131, P=0.007), while cement volume was a protective factor for both types(type B: OR=0.646, 95%CI: 0.474-0.881, P=0.006; type S: OR=0.720, 95%CI: 0.523-0.991, P=0.044). To further explore the underlying mechanism of BFH and cement volume on leakage, further mediation analysis showed no significant mediating effect of cement volume between BFH and CL(95%CI included zero). ROC analysis indicated that BFH had a moderate predictive value for type B leakage(AUC=0.749, cutoff=10.99) and certain predictive utility for type S leakage(AUC=0.684, cutoff=7.55), whereas the amount of bone cement injected did not demonstrate good clinical predictive value for either type B(AUC=0.347) or type S(AUC=0.395) of leakage. Conclusions: The preoperative BFH of the injured vertebra is a common independent risk factor for both type B and type S CL after PVP for OLVCF, and its predictive efficacy for type B leakage is superior to that for type S. |
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