Abstract
BackgroundPercutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector.MethodsWe undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by X-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes.ResultsThere was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. There were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between the two groups at 1 week after PVP, significant difference was observed only 12 months after operation.ConclusionsApplication of flexible cement injector is safe and feasible, compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage; it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.
Highlights
Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF)
Patients We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture PVP from our institution over a 2-month period (June and July 2015). 78 patients were included according to the standard
Inclusion criteria includes: 1 age from 60 to 99 years; 2 bone attenuation (T score < − 2.5) on bone densitometry; 3 collapse more than 15% of the vertebral height; 4 severe back pain related to a single-level AOVF refractory to analgesic medication; 5 using magnetic resonance (MR) imaging, the affected vertebral body showed a hypointense signal on T1-weighted images and hyperintense signal on T2-weighted images
Summary
Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). Bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector. Osteoporotic vertebral fracture is one of the most common diseases of the elderly [1,2,3,4]. Percutaneous vertebroplasty (PVP) is widely used to treat painful vertebral compression fractures and strengthen the stability of vertebrae [5, 6]. Li et al Eur J Med Res (2020) 25:36 asymmetric loading of the vertebral body and collapse of the contralateral side of the vertebral body under axial compression stress [9]
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