Influence of PMMA bone cement combined with calcium sulfate on bone cement leakage and postoperative recovery in elderly patients with osteoporotic vertebral compression fractures

WANG Sen; WANG Changjie

doi:10.3969/j.issn.1674-666X.2025.03.004

Abstract：Objective To investigate the influence of calcium sulfate combined with polymethylmethacrylate(PMMA)bone cement during percutaneous kyphoplasty(PKP)on bone cement leakage and postoperative recovery in elderly patients with osteoporotic vertebral compression fractures(OVCFs).Methods The clinical data of 120 elderly patients with OVCFs who received PKP in Nanyang Zhang Zhongjing Hospital from July 2021 to July 2024 were retrospectively analyzed.According to the different bone cement filling methods during surgery,they were divided into group A(n=63,PMMA bone cement filling only)and group B(n=57,calcium sulfate combined with PMMA bone cement filling).The differences in perioperative parameters,incidence of bone cement leakage,preoperative and postoperative visual analogue scale(VAS),Oswestry disability index(ODI),anterior vertebral height(AVH)and kyphosis Cobb angle,as well as occurrence of complications were compared between the two groups.Results The PMMA bone cement injection volume,incidence of bone cement paravertebral venous leakage and total incidence of bone cement leakage,pain VAS score and ODI at 1 week after surgery in group B were less or lower than those in group A(P<0.05).There were no statistical differences in injured vertebra AVH recovery rate and Cobb angle improvement immediately after surgery and at the last follow-up,as well as incidence of postoperative adjacent vertebral re-fracture between the two groups(P>0.05).No serious complications such as pulmonary embolism,infection,symptomatic nerve root stimulation or spinal cord compression occurred in the two groups.Conclusions The application of calcium sulfate combined with PMMA bone cement during PKP has good safety for elderly patients with OVCFs.The procedure could effectively restore the vertebral height and correct the kyphosis deformity,meanwhile,it could further lower the PMMA bone cement volume,reduce the risk of bone cement leakage,improve the pain symptoms and the vertebral function during early postoperative period,and is more conducive to postoperative early recovery of patients.