Efficacy evaluation of gelatin sponge in percutaneous vertebroplasty for lumbar osteoporosis compression fractures

Objective To evaluate the feasibility of using gelatin sponge to reduce bone cement leakage in percutaneous vertebroplasty (PVP). Methods A retrospective case control study was conducted to analyze the 191 patients (191 vertebrae) with lumbar osteoporosis vertebrae compression fractures (OVCF) who were treated by PVP from October 2014 to October 2017 in Xi'an Honghui Hospital. There were 52 males and 139 females, aged 65-91 years, with an average of 75.1 years. A total of 48 patients were treated with routine PVP, and bone cement was injected directly after puncture (Group A). A total of 47 patients, 49 patients and 47 patients were injected with 1/4, 1/3 and 1/2 gelatin sponge before bone cement injection respectively (Group B, Group C and Group D). Postoperative routine X-ray and CT scans were used to compare the amount of bone cement injection, the leakage of bone cement, the visual analogue score (VAS), neurological symptoms and complications before and after operation. Results All patients were followed up for 1-12 months, with an average of 3.6 months. There were no significant differences in the amount of bone cement injection after operation between groups (P>0.05). There was a significant difference in the cement leakage rate among the groups after operation [Group A: 42%(20/48); Group B: 40%(19/47); Group C: 14%(7/49); Group D: 13%(6/47)](P 0.008 3); significant differences were found between Group B and Group C as well as between Group B and Group D (P 0.05). There were no significant differences in VAS among the groups (P>0.05); VAS was significantly improved after operation within each group (P<0.05). After operation, two patients had persistent lower back pain and one patient had intraspinal leakage. Wound healing was found in all patients, with no neurological symptoms. Conclusion For OVCF, use of 1/3 or 1/2 gelatin sponge in PVP can reduce bone cement leakage. Key words: Osteoprotic fractures; Vertebroplasty; Gelatin sponge, absorbable; Bone cement leakage