Hydraulic Polymethylmethacrylate Pressure Delivery System Versus Manual Balloon Tamp System in Balloon Kyphoplasty

Study DesignRetrospective cohort study.ObjectiveOsteoporotic vertebral compression fractures (VCFs) are prevalent among the elderly population, and Balloon kyphoplasty (BKP) is a minimally invasive solution for these. However, Polymethylmethacrylate (PMMA) leakage is a significant complication with potentially severe consequences. This study compares the safety and efficacy of manual balloon tamp system (MTS) and hydraulic Polymethylmethacrylate pressure delivery system (HPDS) in BKP.MethodsA retrospective study involving 160 patients, comparing MTS (2008-2014) and HPDS (2016-2020) cohorts, assessed PMMA leakage, radiation exposure, and surgery duration.ResultsPMMA leakage occurred in 52.8% of MTS and 62.5% of HPDS cases. Intradiscal leakage was the most common pattern in both groups. Multivariate logistic regression revealed that multilevel BKP and HPDS were associated with higher PMMA leakage rates. Radiation exposure was significantly lower with HPDS, while surgery duration was shorter.DiscussionThis study provides novel insights into PMMA leakage and radiation exposure in BKP. HPDS was associated with a higher PMMA leakage rate. HPDS, however, offers advantages in terms of reduced radiation exposure and shorter surgery duration. Multilevel BKP also increased the risk of leakage. Further investigation is needed to better understand the impact of HPDS on PMMA leakage.ConclusionThis study underscores that while HPDS offers advantages regarding radiation exposure and surgery duration, it is associated with a higher PMMA leakage rate.