Clinical Observation of Two Bone Cement Distribution Modes After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

Abstract

Background:Current findings suggest that percutaneous vertebroplasty(PVP) is a suitable therapeutic approach for osteoporotic vertebral compression fractures (OVCFs).The present retrospective study aimed to investigate the differences in clinical efficacy and related complications between the two bone cement distribution modes. Methods:We retrospectively reviewed the medical records of the patients with single-segment OVCFs who underwent bilateral percutaneous vertebroplasty.Patients were divided into blocky and spongy group according to the type of postoperative bone cement distribution. Clinical efficacy and related complications was compared between the two bone cement distribution modes on 24h after the operation and last follow-up.RESULTS: The mean follow-up time was 17.54 months. The VAS and ODI after operation improved significantly in both two groups. The VAS and ODI in the spongy group was significantly lower than that in the blocky group, 24h postoperatively, and at the last follow-up. There were 42 cases (12.8%) of adjacent vertebral fractures, 26 cases (19.8%) in the blocky group and 16 cases (8.1%) in the spongy group. There were 57 cases (17.3%) of bone cement leakage, 18 cases (13.7%) in blocky group and 39 cases (19.7%) in the spongy group. At 24 hour postoperatively and at the last follow-up, local kyphosis and anterior vertebral height were significantly corrected in both groups, but gradually decreased over time, and the degree of correction was significantly higher in the spongy group than in the block group. Loss of local kyphosis and loss of vertebral body height were also less severe in the spongy group at the last follow-up.Conclusions: Compared with blocky group, spongy group can better maintain the height of the vertebral body, correct local kyphosis, reduce the risk of the vertebral body recompression, long-term pain and restore functions.

PCVP decrease the risk of cemented vertebra refracture compared with PKP: in the treatment of osteoporotic vertebral compression fractures

“…Therefore, only cases with vertebral collapse less than 50% were included in this study. The results of this study suggested that PCVP could signi cantly restore the anterior vertebral height and correct kyphosis, which was consistent with the previous studies using PVP [6,30]. We believe that the recovery of vertebral body height in PCVP is mainly due to body position reduction after taking prone position.…”

“…Yu et al reported that after PVP treatment of OVCF with intervertebral cleft, the distribution pattern of solid block bone cement could lead to a 12.5-fold increase in the risk of vertebral refracture [29]. Compared with mass pattern, spongy pattern can better maintain the vertebral body height and reduce the risk of the cemented vertebral body refracture [ [30]. In this study, 95.75% of the PCVP cases was with spongy pattern and 55.32% of the PKP cases was with mass pattern.…”

Comparison of the curative effect of vertebroplasty with spiral and traditional pushrod injector in the treatment of osteoporotic vertebral fractures

“…Considering the clinical cost and e cacy, PVP is superior to PKP in clinical selection (9). PVP stabilizes the fractured vertebral body in a minimally invasive way, alleviates the lumbar and back pain in the early stage, and can restore the partial height of the vertebral body and correct kyphosis (19). PVP surgery can reduce the risk of vertebral wedge change and nerve injury in OVCF patients, so early surgical treatment should be performed (4).…”

Comparison of unipedicular and bipedicular kyphoplasty for the treatment of osteoporotic vertebral compression fractures in the lower lumbar spine

“…The distribution of bone cement is important for postoperative functional improvement and stabilization of the vertebral body, which likely plays a major role in pain relief [15][16][17][18][19][20] . Tan et al 21 reported that fully distributed bone cement can better restore the strength and maintain the height of the vertebral body.…”