Comparison of the Bone Cement Leakage on Vertebroplasty with High-Viscosity Cement Versus Decompressed Kyphoplasty: A Retrospective Study

Cement leakage is a concerning complication of percutaneous kyphoplasty or vertebroplasty, as it may lead to neurologic injury. High viscosity cement has been recently used in vertebroplasty to prevent cement leakage. In this study, we aimed to compare the results between vertebroplasty with high viscosity cement to a novel technique “decompressed kyphoplasty” that used a low viscosity cement. A total of 136 patients with a single level osteoporotic compression fracture were retrospectively included in our study. 70 patients received vertebroplasty with high viscosity cement while the other 66 patients received decompressed kyphoplasty with low viscosity cement. The overall cement leakage rate was not significantly different between the two groups (18.6% and 9.1%, p = 0.111). However, the risk of intradiscal leakage was lower for the decompressed kyphoplasty group ( p = 0.011), especially when the pre-operative x-ray did not display a cleft sign. The change in the kyphotic angle and the risk of adjacent segment collapse were similar ( p = 0.739 and 0.522 respectively). We concluded that decompressed kyphoplasty can reduce intradiscal cement leakage rate compared to high viscosity cement vertebroplasty. The technique is particularly useful for patient without cleft sign on x-ray to prevent intradiscal leakage.