Comparison of efficacies of unipedicular kyphoplasty and bipedicular kyphoplasty for treatment of single-level osteoporotic vertebral compression fractures

Lee, Chung Hun; Kim, Hyun Joong; Lee, Mi Kyoung; Kim, Hyo Sung; Choi, Sang Sik

doi:10.1097/md.0000000000022046

Cited by 8 publications

(10 citation statements)

References 42 publications

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“…In 2010, Chen et al 13 reported that bipedicular PKP was more effective than unipedicular PKP in improving vertebral height. More recently, in their 2020 study, Lee et al 9 reported no differences in height restoration between the two techniques. We also concluded that both techniques provided similar restoration of vertebral height, with no differences in anterior or middle vertebral heights post-operatively.…”

Section: Discussionmentioning

confidence: 92%

“…Zhang et al 14 reported bone cement leakage rates of 20.8% (5 of 24) in the unipedicular group and 34.6% (9 in 26) in the bipedicular group, which did not differ signi cantly between groups. Lee et al 9 reported no signi cant difference in the leakage rates of cement into the intradiscal space (14% in the unipedicular group and 18% in the bipedicular group). A 2019 meta-analysis by Chen et al concluded that the unilateral approach decreased the incidence of cement leakage in PKP 26 .…”

Section: Discussionmentioning

confidence: 95%

“…In recent years, unipedicular has been advocated because of the shorter operating and radiation exposure times, which lower the risk of cement leakage and complications. Most previous studies have shown that the clinical and radiological results of unipedicular percutaneous kyphoplasty for the treatment of OVCFs are as good as those of bipedicular percutaneous kyphoplasty [7][8][9] . However, previous studies mostly focused on the thoracolumbar spine, there were few reports on the lower lumbar spine (L3--L5).…”

Section: Introductionmentioning

confidence: 99%

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

Qian

Shen

et al. 2022

Preprint

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Background Both unipedicular and bipedicular approaches for percutaneous kyphoplasty are reportedly effective for the treatment of osteoporotic vertebral compression fractures (OVCFs). However, most of the literature has reported on thoracolumbar fractures, with few reports describing the treatment of the lower lumbar spine. This study compared the clinical and radiological results between the unipedicular versus bipedicular approachesfor percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Methods We retrospectively reviewed the records of 160 patients who underwent percutaneous kyphoplasty for lower lumbar (L3–L5) osteoporotic vertebral compression fractures between January 2016 and January 2020. Patient characteristics, surgical outcomes, operation time, blood lose, clinical and radiological features, and complications were compared between the two groups. Cement leakage, height restoration, and cement distribution were calculated from the radiographs. Visual pain analog scale (VAS), the Oswestry disability index (ODI), were calculated before surgery and immediately and 2 years after surgery. Results The results showed significantly improved the visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, and vertebral height restoration in each group (p<0.05), with no significant differences between the two groups (p>0.05). The mean operation time and blood lose in the unipedicular group was less than that in the bipedicular group(p<0.05). Different types of bone cement leakage were observed in both groups. The leakage rate was higher in the bipedicular group than in the unipedicular group. Patients in the bipedicular group showed greater improvement in bone cement distribution compared to that in patients in the unipedicular group (p<0.05). Conclusions Despite the relatively worse cement distribution, unipedicular approach PKP is a safe and minimally invasive surgical method that has the advantages of short operation time, less blood loss and radiation exposure compared to bipedicular approach PKP for OVCFs.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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

Qian

Shen

et al. 2022

Preprint

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“…Also, Lin et al (12) reported that despite the advantages of unilateral puncture, the risk of arteriovenous injury and cement leakage during puncture is significantly increased by increasing the volume of cement injection in order to distribute cement evenly within the vertebral body. In a recent retrospective study, Lee et al (13) pointed out that as a level 3 evidence and grade B recommendation, unipedicular kyphoplasty requires lower amounts of cement than bipedicular kyphoplasty and is as effective as bipedicular kyphoplasty in terms of radiological and clinical outcomes. Furthermore, Cui et al (14) reported that unilateral PKP is superior to bilateral PKP in shortening operation time and bone cement leakage.…”

Section: Advantages and Disadvantages Of Unilateral And Bilateral Pkpmentioning

confidence: 99%

A randomized trial comparing the clinical efficacy and safety of a novel steerable percutaneous kyphoplasty with traditional PKP in osteoporotic vertebral fractures

Li¹,

Yuan²,

Fanbing³

et al. 2021

Ann Transl Med

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Background: Percutaneous kyphoplasty (PKP) is a highly practical technology to treat osteoporotic vertebral compression fractures (OVCFs). However, the operation time and radiation exposure remain problematic. This study explored the differences in surgical effects and safety between a novel steerable percutaneous kyphoplasty (S-PKP) and traditional PKP in order to achieve better clinical outcomes for OVCF patients. It is also exploring whether the new technology could reduce the radiation exposure.Methods: This study recruited 72 patients (between March 2019 and January 2020) with OVCFs (single vertebra). The patients were semi-randomly divided these patients into two groups according to ID numbers: a S-PKP group (33 cases) and a PKP group (39 cases). We evaluated the clinical efficacy using the kyphotic Cobb angle, Oswestry disability index (ODI), visual analogue scale (VAS) score, injected cement volume, operation time, intraoperative radiation times, bone cement leakage, and postoperative complications.Patients were followed up once preoperatively, and at 1 day, 6 months, and 1 year postoperatively.Results: There were no cases of cement leakage or postoperative complications. There were no significant differences in gender, age, Bone mineral density T-score (BMD T) value, Cobb angle between the two groups (P>0.05). Intraoperative bone cement injection was approximately 5.25±1.37 and 5.32±1.29 mL in the PKP and S-PKP groups respectively. The postoperative VAS score and ODI of the two groups at 1 day, 6 months, and 1 year were markedly lower than before (P<0.05). There was a considerable improvement in the Cobb angle postoperatively (P<0.05). However, as the follow-up time extended, the Cobb Angle increased. The operation time and X-ray exposure times of patients in the PKP group were notably higher than those in the S-PKP group. The operation time was 51.59±9.14 min in the PKP group and 30.76±4.82 min in the S-PKP group. The frequency of intraoperative radiation was 105.9±31.93 times in the PKP group and 47.42±11.88 times in the S-PKP group. Conclusions:Early results showed that S-PKP is a safe and efficient method for the treatment of OVCFs. S-PKP can reduce the operation time and radiation exposure.

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“…In recent years, unipedicular approach has been advocated because of shorter operating and radiation exposure times, which can lower the risk of cement leakage and complications. Most previous studies have shown that the clinical and radiological results of unipedicular percutaneous kyphoplasty for OVCFs are similar to those of bipedicular percutaneous kyphoplasty [ 7 – 9 ]. However, the previous studies have mostly focused on the thoracolumbar spine, and there are few reports on the lower lumbar spine (L3–L5).…”

Section: Introductionmentioning

confidence: 96%

Comparison of unipedicular and bipedicular kyphoplasty for treating acute osteoporotic vertebral compression fractures in the lower lumbar spine: a retrospective study

Qian

Shen

et al. 2023

BMC Musculoskelet Disord

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Background Unipedicular and bipedicular approaches for percutaneous kyphoplasty are reportedly both effective in treating osteoporotic vertebral compression fractures (OVCFs). However, most studies have reported thoracolumbar fractures, with few reports describing the treatment of the lower lumbar spine. Here, we compared the clinical and radiological results of unipedicular and bipedicular approaches for percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures. Methods We retrospectively reviewed the records of 160 patients who underwent percutaneous kyphoplasty for lower lumbar (L3–L5) osteoporotic vertebral compression fractures between January 2016 and January 2020. Patient characteristics, surgical outcomes, operation time, blood loss, clinical and radiological features, and complications were compared between two groups. Cement leakage, height restoration, and cement distribution were calculated from the radiographs. Visual pain analog scale (VAS) and Oswestry Disability Index (ODI) were calculated before surgery, immediately post-surgery, and 2 years after surgery. Results The mean age, sex, body mass index, injury time, segmental distribution, and morphological classification of fractures before surgery did not differ significantly between the groups. The results showed significant improvements in the VAS score, ODI score, and vertebral height restoration in each group (p < 0.05), with no significant differences between the two groups (p > 0.05). The mean operation time and extent of blood loss were lower in the unipedicular group than those in the bipedicular group (p < 0.05). Different types of bone cement leakage were observed in both groups. Leakage rate was higher in the bipedicular group than in the unipedicular group. Patients in the bipedicular group showed greater improvement in bone cement distribution than those in the unipedicular group (p < 0.05). Conclusions The clinical and radiological results of unipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures in the lower lumbar region were similar to those of bipedicular percutaneous kyphoplasty. However, the unipedicular approach resulted in shorter surgical time, less blood loss, and less bone cement leakage. Thus, the unipedicular approach may be preferable owing to its several advantages.

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Comparison of efficacies of unipedicular kyphoplasty and bipedicular kyphoplasty for treatment of single-level osteoporotic vertebral compression fractures

Abstract: Supplemental Digital Content is available in the text

Cited by 8 publications

References 42 publications

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

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

A randomized trial comparing the clinical efficacy and safety of a novel steerable percutaneous kyphoplasty with traditional PKP in osteoporotic vertebral fractures

Comparison of unipedicular and bipedicular kyphoplasty for treating acute osteoporotic vertebral compression fractures in the lower lumbar spine: a retrospective study

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