Application of contralateral supplementary puncture in unilateral percutaneous vertebroplasty for poor bone cement dispersion

Abstract

To evaluate the clinical value of contralateral supplementary puncture in unilateral percutaneous vertebroplasty(PVP) with poor cement dispersion. From January 2015 to December 2016, PVP was performed unilaterally in 285 patients(319 vertebrae) with osteoporotic compression fractures(OVCF). Contralateral percutaneous puncture was performed in 13 patients with poor cement dispersion. Among the patients, 5 cases were male and 8 patients were female, ranging in age from 63 to 88 years old; 1 case of T₁₁, 4 cases of T₁₂, 3 cases of L₁, 2 cases of L₂, 1 case of L₃, and 2 cases of L₅. The time from injury to operation ranged from 1 to 16 days. The VAS score, ODI score, residual low back pain and loss of vertebral height were observed. The VAS score and ODI score of 13 patients who underwent contralateral supplementary puncture were significantly improved (P<0.01), and there was no postoperative residual low back pain. During the follow-up period, there was no significant difference in the height loss between the two sides of the vertebral body (0.35 to 3.69 mm on the original puncture side and 0.59 to 3.66 mm on the supplementary puncture side). For unilateral PVP with poor cement dispersion, contralateral puncture can reduce the occurrence of postoperative residual pain; at the same time, can reduce the difference between the loss of height on both sides of the vertebral body, and then prevent the occurrence of lateral vertebral deformity, which is a safe and reliable method.