🧪 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.