🧪 Cement Leakage [Neurosurgery Wiki]

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====== 🧪 Cement Leakage ======

Cement leakage is a potential complication of vertebral augmentation procedures such as vertebroplasty or balloon kyphoplasty (BKP), where bone cement (usually polymethylmethacrylate, PMMA) unintentionally escapes outside the targeted vertebral body during injection.

🔍 Where the cement can leak:
Paravertebral soft tissues

Intervertebral disc space

Epidural space

Venous system (risk of pulmonary embolism if systemic)

⚠️ Why it matters:
Often asymptomatic, but in some cases it may lead to:

Radicular pain or neurological deficits (if into spinal canal)

Infection

Pulmonary cement embolism

Adjacent vertebral fractures (if into disc space)

🧠 Risk factors:
High-pressure cement injection

Low viscosity cement

Cortical wall disruption

No balloon cavity (as in vertebroplasty)

✅ Prevention strategies:
Using balloon kyphoplasty to create a cavity and reduce injection pressure.

Carefully monitoring cement flow under fluoroscopy.

Choosing the appropriate cement viscosity and volume.