The Role of Pre-soaked Bone Cement Gelatin Sponge Strips in Sealing Anterior Vertebral Wall Defects During Percutaneous Kyphoplasty for Osteoporotic Thoracolumbar Compression Fractures in the Elderly: A Retrospective Study.

Abstract

Study DesignRetrospective cohort study.ObjectivesUnilateral percutaneous kyphoplasty (PKP) is widely used to treat osteoporotic vertebral compression fractures (OVCF) in elderly patients. Cement leakage is the most common complication and may cause serious consequences. Although various techniques have been proposed to reduce leakage, few studies have addressed cases with preexisting anterior vertebral wall defects. This study aims to evaluate whether intraoperative sealing of these defects with gelatin sponge strips pre-soaked in bone cement can reduce leakage and improve surgical outcomes.MethodsA retrospective analysis was conducted on 86 patients who underwent unilateral single-level PKP for thoracolumbar OVCF from December 2021 to October 2024. All patients had preoperative cortical defects in the anterior vertebral wall and were divided into two groups: Group A (n = 43) received conventional PKP, while Group B (n = 43) underwent PKP with defect sealing using pre-soaked gelatin sponge strips. Clinical and radiological assessments were performed preoperatively, immediately postoperatively, at 3 months, and at 12 months.ResultsBoth groups achieved favorable outcomes without severe complications. Cement leakage at the anterior vertebral wall was significantly lower in Group B than in Group A (<i>P</i> = 0.007). Group B also demonstrated better cement diffusion (<i>P</i> = 0.013) and a higher cement injection volume (<i>P</i> = 0.022).ConclusionsIn elderly patients with thoracolumbar OVCF and anterior vertebral cortical defects, unilateral puncture PKP combined with bone cement-soaked gelatin sponge strips effectively reduces anterior vertebral wall cement leakage and improves cement distribution, which may contribute to better procedural safety and stability.