Improved percutaneous vertebroplasty for osteoporotic vertebral compression fractures

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Objective To evaluate the curative efficacy of improved percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fractures (OVCF) in comparison with conventional PVP and percutaneous kyphoplasty (PKP). Methods Between June 2007 and July 2010,97 senior OVCF patients were surgically treated and followed up in our department.They were 36 men and 61 women,with an average age of 68.3 years (ranging from 56 to 89 years).Altogether 124 vertebral bodies were treated,including 73 thoracic vertebrae and 51 lumbar vertebrae.Seventy-four patients had a single vertebra fractured,19 had 2 vertebrae fractured and 4 had 3 vertebrae fractured.The patients received improved PVP,conventional PVP and PKP respectively.The visual analogue scale (VAS) scores and the cobb angles of the injured vertebra before operation,one week and 6 months after operation and the postoperative cement leakage as well were compared between the 3 groups of patients. Results The patients obtained an average follow-up of 13 months (from 7 to 20 months).Mild radicular symptoms were observed in 3 patients.No spinal injury,infection or vascular embolism occurred.There was a significant difference between the preoperative and postoperative VAS scores in all the 3 groups( P ＜ 0.05) but there was no significant difference among the 3 groups regarding the VAS score at the same time point ( P ＞ 0.05). PKP and improved PVP were significantly better than conventional PVP in correction of the cobb angle ( P ＜ 0.05).Moreover,PKP and improved PVP resulted in significantly fewer events of cement leakage than conventional PVP ( P ＜ 0.05). Conclusions Compared with conventional PVP,improved PVP makes a significant improvement in correction of vertebral kyphosis and reduction of cement leakage while it can also rapidly relieve pain in patients with OVCF.Improved PVP is as therapeutically effective as PKP,but much less expensive than PKP. Key words: Spinal fractures; Osteoporosis; Vertebroplasty