Osteoporosis is the most prevalent metabolic bone disease, and it is characterized by the depletion of bone mineral density and impaired bone strength. It is the leading cause of vertebral compression fractures. Osteoporotic vertebral compression fractures (OVCFs) are a common cause of both acute and chronic back pain among older individuals, often resulting in substantial spinal deformity, functional limitation, respiratory compromise, and diminished quality of life [1]. Balloon kyphoplasty (BKP) is a minimally invasive surgical technique for percutaneous vertebroplasty in patients with OVCFs who do not respond to conservative treatment [2]. BKP not only provides relief from pain but also enhances the prompt management of spinal fractures, which is critical in preventing secondary complications arising from the limited mobility associated with inadequately treated fractures [3]. The goal of kyphoplasty is to alleviate pain, stabilize the fractured vertebra, and restore the vertebra’s height and alignment [4].

Although kyphoplasty procedures are minimally invasive, they are associated with numerous complications. These complications are generally rare, with some occurring at rates as low as ≤1% and most being asymptomatic [1]. However, a few of these complications can be severe, leading to significant morbidity. Cement extravasation has been reported to occur in approximately 9% of cases of BKP [5]. The incidence of pulmonary complications was reported to be in the range of 1%–6.8%, as determined on postprocedural chest X-ray scans, and 2.1%–26%, as determined on chest computed tomography (CT) scans [6]. Most patients with pulmonary cement embolism are asymptomatic; symptomatic pulmonary cement embolism is rare, with its incidence being as low as 0.01% [4], [7]. Neurologic deficits, while uncommon, have been reported to have an incidence of 0.03% [4], [5].

Numerous studies have identified a range of risk factors for residual back pain following surgery [8]. The factors influencing bone cement dislodgment (BCD) following BKP remain unclear, and comprehensive investigations into this topic are lacking. Some scholars have postulated that inadequate adhesion of bone cement to cancellous bone may lead to the displacement or migration of bone cement, potentially resulting in vertebral collapse, spinal instability, and consequent symptoms such as persistent pain, exacerbation of kyphosis, and neurological impairment [9]. Therefore, the current study analyzed the incidence of and independent risk factors for BCD following BKP.