Appropriate Cement Volume in Vertebroplasty: A Multivariate Analysis with Short-Term Follow-Up

OBJECTIVE The optimal threshold of the infusion volume of cement has been a continuous subject in percutaneous vertebroplasty (PVP). This study verifies a causal relationship between the cement volume and the clinical outcome, and suggests the parameters of the appropriate volume of cement in PVP. METHODS This is a retrospective study. One hundred nine patients, who underwent PVP between 2012 and 2015, were included in the study. Various factors such as patients' fracture levels, fracture types, fracture body volumes, fracture rates, bone mineral densities, and infused cement volumes were analyzed. Cement infusion ratios were calculated, using total amount of infused cement and fractured body volume. Follow up was done after one-week, one-month and three-months, postoperatively. Changes in the middle body height and the cement leakage levels were monitored and clinical outcomes were evaluated using a visual analogue scale. RESULTS Among the variables, the infusion ratio (r=-0.320, p=0.003, Pearson's correlation) was the only index that showed a significant cause and effect relationship with favorable clinical outcome, except the group with a T-score of higher than -2.5, and the group with a upper thoracic vertebral level. The patients with a cement infusion ratio of 27.8% or more of the fractured body volume had favorable results. CONCLUSION This study showed that high cement infusion ratio revealed favorable outcome in the vertebroplasty of the osteoporotic compression fractures. Infusion ratio of more than 27.8% to osteoporotic compressed vertebrae is optimal for rapid recovery after PVP.