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논문 기본 정보

자료유형
학술저널
저자정보
Huizhi Guo (The first Institute of Clinical Medicine Guangzhou University of Chinese Medicine) Huasheng Huang (The first Institute of Clinical Medicine Guangzhou University of Chinese Medicine) Yang Shao (The first Institute of Clinical Medicine Guangzhou University of Chinese Medicine) Qiuli Qin (The first Institute of Clinical Medicine Guangzhou University of Chinese Medicine) De Liang (Spine Surgery Department The First Affiliated Hospital of Guangzhou University of Chinese Medicine) Shuncong Zhang (Spine Surgery Department The First Affiliated Hospital of Guangzhou University of Chinese Medicine) Yongchao Tang (Spine Surgery Department The First Affiliated Hospital of Guangzhou University of Chinese Medicine)
저널정보
대한척추신경외과학회 Neurospine Neurospine 제18권 제4호
발행연도
2021.12
수록면
806 - 815 (10page)
DOI
10.14245/ns.2142616.308

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Objective: Pulmonary cement embolism (PCE) is an underestimated but potentially fatal complication after cement augmentation. Although the treatment and follow-up of PCE have been reported in the literature, the risk factors for PCE are so far less investigated. This study aims to identify the preoperative and intraoperative risk factors for the development of PCE. Methods: A total of 1,373 patients treated with the polymethylmethacrylate (PMMA) augmentation technique were retrospectively included. Patients with PCE were divided into vertebral augmentation group and screw augmentation group. Possible risk factors were collected as follows: age, sex, bone mineral density, body mass index, diagnosis, comorbidity, surgical procedure, type of screw, augmented level, number of augmented vertebrae, fracture severity, presence of intravertebral cleft, cement volume, marked leakage in the paravertebral venous plexus, and periods of surgery. Binary logistic regression analyses were used to analyze independent risk factors for PCE. Results: PCE was identified in 32 patients, with an incidence rate of 2.33% (32 of 1,373). For patients who had undergone vertebral augmentation, marked leakage in the paravertebral venous plexus (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.1?10.3; p=0.000) and previous surgery (OR, 16.1; 95% CI, 4.2?61.0; p=0.007) were independent risk factors for PCE. Regarding patients who had undergone screw augmentation, the marked leakage in the paravertebral venous plexus (OR, 4.2; 95% CI, 0.5?37.3; p=0.004) was the main risk factor. Conclusion: Marked leakage in the paravertebral venous plexus and previous surgery were significant risk factors related to PCE. Paravertebral leakage and operator experience should be concerned when performing PMMA augmentation.
#Pulmonary embolism #Polymethylmethacrylate #Augmentation #Risk factors

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참고문헌 (41)

참고문헌 신청
Galibert P / 1987 / Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty / Neurochirurgie 33:166~168 google schola Guo HZ / 2020 / Influence of cementaugmented pedicle screws with different volumes of polymethylmethacrylate in osteoporotic lumbar vertebrae over the adjacent segments : a 3D finite element analysis / BMC Musculoskelet Disord 21:460 google schola Lv B / 2020 / Clinical efficacy of different bone cement distribution patterns in percutaneous kyphoplasty : a retrospective study / Pain Physician 23:E409~E416 google schola Liu D / 2016 / Biomechanical comparison of pedicle screw augmented with different volumes of polymethylmethacrylate in osteoporotic and severely osteoporotic cadaveric lumbar vertebrae : an experimental study / Spine J 16:1124~1132 google schola Guo HZ / 2019 / The cement leakage in cement-augmented pedicle screw instrumentation in degenerative lumbosacral diseases : a retrospective analysis of 202 cases and 950 augmented pedicle screws / Eur Spine J 28:1661~1669 google schola

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