Assessment of Cement Leakage in Decompressed Percutaneous Kyphoplasty

Shih Hao Cheng, Wen Hsiang Chou, Yu Chuan Tsuei, William Chu, Woei Chyn Chu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Symptomatic osteoporotic compression fractures are commonly addressed through vertebroplasty and kyphoplasty. However, cement leakage poses a significant risk of neurological damage. We introduced “aspiration percutaneous kyphoplasty”, also known as “decompressed kyphoplasty”, as a method to mitigate cement leakage and conducted a comparative analysis with high viscosity cement vertebroplasty. We conducted a retrospective study that included 136 patients with single-level osteoporotic compression fractures. Among them, 70 patients underwent high viscosity cement vertebroplasty, while 66 patients received decompressed percutaneous kyphoplasty with low-viscosity cement. Comparison parameters included cement leakage rates, kyphotic angle alterations, and the occurrence of adjacent segment fractures. The overall cement leakage rate favored the decompressed kyphoplasty group (9.1% vs. 18.6%), although statistical significance was not achieved (p = 0.111). Nonetheless, the risk of intradiscal leakage significantly reduced in the decompressed kyphoplasty cohort (p = 0.011), which was particularly evident in cases lacking the preoperative cleft sign on X-rays. Kyphotic angle changes and the risk of adjacent segment collapse exhibited similar outcomes (p = 0.739 and 0.522, respectively). We concluded that decompressed kyphoplasty demonstrates efficacy in reducing intradiscal cement leakage, particularly benefiting patients without the preoperative cleft sign on X-rays by preventing intradiscal leakage.

Original languageEnglish
Article number345
JournalJournal of Clinical Medicine
Issue number2
StatePublished - Jan 2024


  • cement leakage
  • high-viscosity cement
  • kyphoplasty
  • osteoporotic compression fracture
  • vertebroplasty


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