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Impact of the quantity of intradiscal cement leak on the progression of intervertebral disc degeneration.

Abstract Introduction We aim to assess the impact of the quantity of intradiscal cement leak during kyphoplasty on the rate of progression of degenerative changes in the affected disc. Methods Of 316 kyphoplasty procedures, we identified 32 episodes of intradiscal cement leak in 26 patients. The quantity of cement leaked was graded from I to IV. Disc degenerative changes were assessed at presentation and follow-up using radiographical scoring and magnetic resonance imaging (MRI) grading systems. Data for low-grade leaks (grade I) were compared with the medium- and high-grade leaks (grades II-IV) using a chi-squared test. Results Median follow-up radiographic and MRI assessments were made at 18 and 21 months, respectively. Medium- and high-grade leaks were associated with a significantly higher radiographic disc degeneration scores compared with low-grade leaks (P = 0.04295) but no difference was found in MRI disc degeneration grades and in adjacent vertebral fracture rates. Conclusions Our findings indicate that the quantity of cement leaking into the disc space significantly influences the rate of progression of disc degeneration.
PMID
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Authors

Mayor MeshTerms
Keywords

Disc degeneration

Intradiscal cement leak

Osteoporosis

Percutaneous balloon kyphoplasty

Vertebral fracture

Journal Title annals of the royal college of surgeons of england
Publication Year Start




PMID- 28853606
OWN - NLM
STAT- MEDLINE
DA  - 20170830
DCOM- 20170913
LR  - 20170913
IS  - 1478-7083 (Electronic)
IS  - 0035-8843 (Linking)
VI  - 99
IP  - 7
DP  - 2017 Sep
TI  - Impact of the quantity of intradiscal cement leak on the progression of
      intervertebral disc degeneration.
PG  - 529-533
LID - 10.1308/rcsann.2017.0083 [doi]
AB  - Introduction We aim to assess the impact of the quantity of intradiscal cement
      leak during kyphoplasty on the rate of progression of degenerative changes in the
      affected disc. Methods Of 316 kyphoplasty procedures, we identified 32 episodes
      of intradiscal cement leak in 26 patients. The quantity of cement leaked was
      graded from I to IV. Disc degenerative changes were assessed at presentation and 
      follow-up using radiographical scoring and magnetic resonance imaging (MRI)
      grading systems. Data for low-grade leaks (grade I) were compared with the
      medium- and high-grade leaks (grades II-IV) using a chi-squared test. Results
      Median follow-up radiographic and MRI assessments were made at 18 and 21 months, 
      respectively. Medium- and high-grade leaks were associated with a significantly
      higher radiographic disc degeneration scores compared with low-grade leaks (P =
      0.04295) but no difference was found in MRI disc degeneration grades and in
      adjacent vertebral fracture rates. Conclusions Our findings indicate that the
      quantity of cement leaking into the disc space significantly influences the rate 
      of progression of disc degeneration.
FAU - Jamjoom, B
AU  - Jamjoom B
AD  - Department of Trauma and Orthopaedics, Royal Derby Hospital , Derby , UK.
FAU - Patel, S
AU  - Patel S
AD  - Department of Trauma and Orthopaedics, Royal Derby Hospital , Derby , UK.
FAU - Bommireddy, R
AU  - Bommireddy R
AD  - Department of Trauma and Orthopaedics, Royal Derby Hospital , Derby , UK.
FAU - Klezl, Z
AU  - Klezl Z
AD  - Department of Trauma and Orthopaedics, Royal Derby Hospital , Derby , UK.
AD  - Department of Surgery, Charles University , Prague , Czech Republic.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ann R Coll Surg Engl
JT  - Annals of the Royal College of Surgeons of England
JID - 7506860
RN  - 0 (Bone Cements)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Cements/therapeutic use
MH  - Disease Progression
MH  - Humans
MH  - Intervertebral Disc Degeneration/diagnostic imaging/*surgery
MH  - Kyphoplasty/*adverse effects/methods
MH  - Magnetic Resonance Imaging
MH  - Middle Aged
MH  - Postoperative Complications/etiology
MH  - Radiography
MH  - Time Factors
OTO - NOTNLM
OT  - Disc degeneration
OT  - Intradiscal cement leak
OT  - Osteoporosis
OT  - Percutaneous balloon kyphoplasty
OT  - Vertebral fracture
EDAT- 2017/08/31 06:00
MHDA- 2017/09/14 06:00
CRDT- 2017/08/31 06:00
AID - 10.1308/rcsann.2017.0083 [doi]
PST - ppublish
SO  - Ann R Coll Surg Engl. 2017 Sep;99(7):529-533. doi: 10.1308/rcsann.2017.0083.