Percutaneous kyphoplasty via the uni-extrapedicular approach for treatment of lower osteoporotic vertebral compression fractures

Abstract

Objective To investigate the clinical efficacy and safety of the uni-extrapedicular percutaneous kyphoplasty (PKP) versus the unipedicular PKP in the treatment of lower osteoporotic vertebral compression fractures (OVCF). Methods From January 2011 to January 2013, 47 patients with lower OVCF were treated at our department. The uni-extrapedicular PKP was conducted for 25 of them (28 compressed vertebrae, group A) while the unipedicular PKP for the other 22 (24 compressed vertebrae, group B). The 2 groups were compatible, showing no significant differences in preoperative clinical data (P>0.05). The 2 groups were compared in terms of operation time, fluoroscopy frequency, volume of injected cement, cement leakage, and cobb angle, anterior vertebral height, visual analogue scale (VAS) score, Oswestry disability index (ODI), SF-36 score, and cement filling preoperatively, 3 days and one year postoperatively. Results All the patients had an uneventful operation and were followed up for at least one year. Compared with group B, group A reported significantly shorter operation time, lower fluoroscopy frequency, less cement leakage, better cement filling, and a lower rate of fracture of adjacent vertebra (all P 0.05). Conclusion Both of the 2 methods are safe and effective treatments of OVCF, but the uni-extrapedicular PKP may be more advantageous because it leads to shorter operation time and lower fluoroscopy frequency. Key words: Thoracic vertebrae; Fractures, bone; Osteoporosis; Vertebroplasty; Cement