Risk Factors for Bone Cement Displacement After Percutaneous Kyphoplasty in Osteoporotic Vertebral Fractures: A Retrospective Analysis

BACKGROUND Bone cement displacement (BCD), which has received increasing attention from scholars, is a serious complication following vertebroplasty in patients with osteoporotic vertebral fractures (OVFs), and percutaneous kyphoplasty (PKP) might promote its occurrence. However, few studies have systematically explored the risk factors of BCD after PKP. This research aimed to study the risk factors for BCD following PKP. MATERIAL AND METHODS The clinical data of patients with OVFs treated with PKP from June 2016 to August 2022 in our department were retrospectively reviewed. Patients were categorized into the bone cement displacement group and the bone cement non-displacement group. Data on the subjects and their radiologic images were gathered for univariate analysis and binary logistic regression analysis. The receiver operating characteristic (ROC) curve and confusion matrix were utilized to assess the discrimination ability. RESULTS We included 181 patients, of which 12 had BCD after PKP. Binary logistic regression analysis revealed that independent risk factors associated with BCD after PKP were: high BMI, high restoration rate of the Cobb angle, high distance between the bone cement and the vertebral endplates, and presence of bone cement leakage. The ROC curve and confusion matrix indicates that logistic regression exhibited a strong predictive value for BCD. CONCLUSIONS Patients with a high BMI, a high restoration rate of the Cobb angle, a high distance between the bone cement and the vertebral endplates, and bone cement leakage have an increased risk of BCD after PKP.