Xiaoming ZHAO, Yingang ZHANG, Jun GAO
Eurasian Journal of Medicine and Oncology - 2026;10(4):1-13
Introduction : Osteoporotic vertebral compression fractures (OVCFs) are a major source of pain and disability in older adults. Percutaneous vertebroplasty and kyphoplasty stabilize the fractured vertebra and often provide rapid analgesia, yet procedure-related events remain clinically relevant. In particular, the behavior of polymethyl methacrylate (PMMA) cement-leakage, endplate breach, and nonuniform fill-can be underrecognized without targeted imaging follow-up. Such characterization may guide safer injection technique and postoperative surveillance strategies. Objective : This study aims to evaluate the incidence and imaging characteristics of postoperative complications after vertebral augmentation in patients with OVCFs and to provide hypothesis-generating clinical imaging observations. Methods : Clinical and imaging data from patients with OVCFs who underwent percutaneous vertebroplasty or percutaneous kyphoplasty at three medical centers between 2023 and 2025 were retrospectively reviewed. A single commercial low-viscosity PMMA cement product was used intraoperatively for all patients. The types and incidence of complications during postoperative follow-up were systematically recorded, and descriptive analyses were performed alongside imaging findings. Results : Among 102 patients (154 treated vertebrae; >=12-month follow-up), 41 developed postoperative complications. Cement-related findings were frequent: leakage in 11 patients (10.78%), uneven intravertebral distribution in 8, cement penetration through the endplate into the intervertebral disc in 5, and aseptic loosening or displacement in 7. Six patients had adjacent vertebral refractures and two had other adverse events. Most complications caused no severe neurological dysfunction and improved with symptomatic treatment. Imaging follow-up revealed recurring patterns of location and morphology across complication categories. Conclusion : Postoperative complications after vertebral augmentation for OVCFs were heterogeneous, with cement-related imaging findings being relatively common. This descriptive observational imaging series summarizes these patterns and situates them within prior literature on PMMA behavior, generating hypotheses for future prospective, quantitative, and biomechanical investigations.
