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.