Analysis of the correlation between the volume fraction of bone cement distribution and the prognosis of patients with PKP

ZHOU Xin; FENG Xiao-jun; WANG Tian-qi; YUAN Hai-tao; GU Jun

doi:10.3969/j.issn.2095-252X.2026.01.006

Abstract：Objective To investigate the relationship between the percentage of cement volume bone fraction(CVBF)and bone cement leakage,adjacent vertebral fracture andpain relief in percutaneous kyphoplasty(PKP)in patients with osteoporotic vertebral compression fractures(OVCFs),and to explore the optimal interval of CVBF.Methods 141 patients with OVCF who underwent PKP treatment in our hospital between December 2022 and December 2024 were selected,and 3 months postoperatively was chosen as the end of follow-up.The study was optimized using a finite element analysis(FEA)model,and the patients were divided into a cement leakage group and a cement non-leakage group,a pain relief group and a pain non-relief group,and an adjacent vertebral fracture group and an adjacent vertebral non-fracture group according to their prognosis,and the CVBF values of the patients with different prognostic relationships were recorded for analysis and comparison.The accuracy of predicting bone cement leakage,adjacent vertebral fracture,and pain relief by CVBF was assessed using receiver operating characteristic(ROC)curves.Results Of the 141 patients,18 had bone cement leakage,23 had adjacent vertebral fractures,and 24 still had unrelieved pain after surgery.The group with cement leakage was significantly higher than the group without leakage,the group with no pain relief was significantly lower than the group with pain relief,and the group with adjacent vertebral fracture was significantly lower than the group with no adjacent vertebral fracture.The occurrence of bone cement leakage and adjacent vertebral fracture were concentrated in high CVBF,which was significantly higher than the occurrence of no bone cement leakage and no adjacent vertebral fracture(P<0.05),and the absence of pain relief was concentrated in low CVBF,which was significantly lower than that of the patients who had pain relief(P<0.05).The ROC curves constructed by the CVBF predicted the different prognostic relationships with an area under the curve(AUC)value of 0.847,respectively,0.877,and 0.867,which were all greater than 0.80.Conclusions There is a strong association between CVBF and the prognosis of OVCF patients after PKP.High CVBF has a significant analgesic effect,but the risks of adjacent vertebral fracture and bone cement leakage are also elevated.The rate of cement penetration is low,the rate of adjacent vertebral fracture is low,and there is a relief of pain when the CVBF is between 24.39%and 34.23%,which is the optimal distribution interval of CVBF.