Extrapedicular unilateral percutaneous vertebroplasty via transverse process for osteoporotic vertebral compression fractures of upper lumbar

Abstract

Objective To investigate the effect of transverse extrapedicular unilateral percutaneous vertebroplasty (PVP) via transverse process in treating the osteoporotic vertebral compression fractures. Methods A retrospective study was performed on 16 patients with osteoporotic vertebral compression fractures of upper lumbar treated from August 2016 through December 2016. There were seven males and nine females, at a mean age of 73.5 years (range, 62-90 years). All the patients reported severe back pain, with an average history of 2 weeks (range, 1-24 weeks). MRI confirmed the diagnosis of osteoporotic vertebral compression fractures, and the compression degree of the affected vertebral body was (25.4±5.3)%. All the patients were treated with extrapedicular unilateral PVP via transverse process under local anesthesia. The operation time, fluoroscopy frequency, bone cement injection volume, and bone cement dispersion were recorded. Back pain and function recovery were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI), respectively. Results All patients were followed up for 6-12 months (mean, 8 months). All operations were successful without complications. The average operation time was 20 min (range, 15-30 minutes), and there were 3-6 times of fluoroscopy with successful incubation. The average volume of bone cement injected to each injured vertebral body was 6.2 ml (range, 5-9 m1). The bone cement dispersed satisfactorily in the vertebral body. Complete relief of lumbar and back pain was achieved in 14 patients, and remarkable relief in two patients. The postoperative VAS and ODI at 24 hours, 72 hours, and 6 months were significantly lower than those before operation (P<0.01). Conclusion Extrapedicular unilateral percutaneous vertebroplasty via transverse process has the advantages of uniform fractured bone cement perfusion, significant pain relief, and rapid recovery, and hence is a simple, safe and effective treatment for osteoporotic vertebral compression fractures of the upper lumbar vertebrae. Key words: Spinal fractures; Osteoporotic fractures; Vertebroplasty; Spinal puncture