Clinical effects of types of bone cement distribution in percutaneous kyphoplasty

Abstract

Objective To investigate the impact of various distribution of bone cement on the early clinical outcomes in osteoporotic vertebral compression fracture (OVCF) patients treated with percutaneous kyphoplasty (PKP). Methods A total of 312 patients (54 males and 258 females, mean age 69.37 years) who diagnosed as OVCF and received PKP treatment from January 2015 to July 2017 were enrolled in the present study. All subjects were divided into two groups according to different distribution of bone cement: the shaped distribution (group O, 113 cases), in which bone cement in the vertebral body presented whole crumb, no separation or loss of bone cement, and the shaped distribution (group H, 199 cases), in which bone cement in the vertebral body presented two briquettes, connected with or without a small amount of bone cement. Demographic data, surgical details, radiographic data, and clinical outcomes (at preoperatively, two-days and one-year follow-up) were compared between the two groups. Results There was no significant difference in bone mineral density (BMD), operation duration, blood loss, and occurrence of leakage of bone cement between two groups. In comparison with group O, group H was accompanied with higher volume of injected bone cement and higher proportion of bilateral approach (P<0.05). Both groups achieved significant improvement of VAS scores after surgery, while the group H had a dramatical reduction of VAS scores at one-year follow-up compared with two-days follow-up (P<0.05). In addition, group H had a better restoration of VAS scores at one-year follow-up than group O (P<0.05), though no significant difference was observed at preoperative and two-days follow-up. Both groups achieved significant improvement of radiographic data after surgery (P<0.05) with similar effects of correction. Conclusion Either shaped or shaped distribution of bone cement can obtain satisfied early clinical effects of PKP for the treatment of OVCF. Compared with shaped distribution, shaped distribution can achieve better pain relief at early follow-up. Key words: Osteoporosis; Fractures, compression; Kyphoplasty