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Objective:To compare the clinical outcomes of percutaneous vertebroplasty (PVP) and the Vesselplasty for kümmell′s disease.Methods:A retrospective case-control study was used.The clinical data of 62 patients with kümmell′s disease were selected in Beijing Friendship Hospital, Capital Medical University, from January 2017 to January 2019. There were 19 males and 43 females, aged (70.94±7.69) years, with range from 60 to 85 years. The patients were divided into two groups according to different operation methods. The 36 patients treated by PVP and 26 patients treated by Vesselplasty were followed up at least one year after operation. The follow-up time was (17.55±4.22) months. The operation time, incidence of cement leakage, preoperative and postoperative Cobb′s angle, visual analogue score (VAS) 1 week and 1 year after operation were observed. The measurement data were expressed as mean±standard deviation ( Mean± SD), independent sample t-test was used for comparison between groups. The count data were expressed as percentage (%), chi-square test was used for comparison between groups. Results:All the operation was successfully completed. No serious complications such as paraplegia, bone cement allergy, pulmonary embolism were occurred. The operation time was no significant difference between the two groups ( P< 0.05). The incidence of cement leakag was 41.67% (15/36) in PVP group and 11.54% (3/26) in Vesselplasty group. The latter was significantly lower than the former, with statistically significant differences between the two groups ( P< 0.05). In PVP group, the Cobb′s angles of preoperation, postoperation 1 year and difference were (26.23 ± 5.62)°, (17.46 ± 3.01)° and (8.78 ± 4.62)°, respectively, in Vesselplasty group, they were (28.74 ± 6.68)°, (16.68 ± 2.79)° and (12.07 ± 5.72)°, respectively. Cobb′s angle of the two groups was significantly improved after operation. In the comparison between the groups, the improvement of the Cobb′s angle in the Vesseplasty group was better than that of the PVP group, and the difference was statistically significant ( P< 0.05). The VAS score in PVP group was (8.42±1.03) scores in preoperation, (3.06±1.01) scores in 1 week, (0.81±0.75) scores in 1 year. The VAS score in Vesselplasty group was (8.35±1.02) scores in preoperation, (2.88±1.11) scores in 1 week and (1.04±0.87) scores in 1 year. Compared with pre-operation, the VAS scores of the two groups decreased significantly at 1 week and 1 year after operation, and the difference was statistically significant ( P<0.05). There was no significant difference in VAS between groups 1 week after operation and 1 year after operation ( P>0.05). Conclusion:Vesselplasty can effectively control the flow and distribution of bone cement in the vertebral body, effectively reduce the leakage of bone cement, and better correct kyphosis.
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Objective To compare the clinical outcomes of unilateral extreme extrapedicular puncture versus bilateral transpedicular puncture in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture.Methods A prospective cohort study was performed.Ninety-seven patients of osteoporotic vertebral compression fractures treated were selected from January 2016 to January 2018 in Beijing Friendship Hospital,Capital Medical University.There were 36 males and 61 females,aged (72.19 ±7.41) years,with an age range of 60-80 years.All the patients underwent PVP with different puncture methods were divided into unilateral puncture group(n =52) and bilateral puncture group(n =45).PVP was performed in the unilateral extreme extrapedicular puncture group by unilateral puncture of the pedicle,and PVP was performed by bilateral puncture of the pedicle in the bilateral transpedicular puncture group.All patients completed at least one year of follow-up after operation.The operation time,fluoroscopy times,cement volume,incidence of cement leakage,visual analogue score (VAS) of 1 week and 1 year after operation were observed.The measurement data were expressed as mean ± standard deviation (Mean ± SD),count data were expressed as percentage,the independent sample t test and the x2 test were used for comparison between groups,and the paired t test was used for comparison within the group.Results The operation was successfully completed in both groups.No serious complications such as paraplegia,bone cement allergy,pulmonary embolism were occurred.In the unilateral puncture group,the operation time were (21.90 ± 3.16) min,the fluoroscopy times were (15.46 ± 2.86) times,the cement volume were (3.47 ± 0.41) ml and the incidence of cement leakage was 44.23％ (23/52),in the bilateral puncture group,the operation time were (31.64±6.90) min,the fluoroscopy times were (23.31 ± 2.39) times,the cement volume were (4.66 ± 0.61) ml and the incidence of cement leakage was 68.89％ (31/45).The operation time,fluoroscopy times,cement volume and incidence of cement leakage of unilateral puncture group were significantly less than those of bilateral puncture group.The difference was statistically significant (P ＜ 0.05).The VAS score in unilateral puncture group was (8.18 ± 0.77) scores in preoperation,(3.39 ± 0.69) scores in 1 week,(1.07 ± 0.90) scores in 1 year.The VAS score in bilateral puncture group was (7.93 ± 0.92) scores in preoperation,(3.14 ±0.83) scores in 1 week and (0.90 ±0.82) scores in 1 year.Compared with pre-operation,the VAS scores of the two groups decreased significantly at 1 week and 1 year after operation,and the difference was statistically significant (P ＜ 0.05).However,there was no significant difference in VAS between groups at 1 week after operation and 1 year after operation (P ＞ 0.05).Conclusions Compared with bilateral transpedicular puncture,PVP through unilateral extrapedicular puncture can achieve the same clinical effect.However,the latter can significantly reduce the operation time,the cement volume,fluoroscopy times and the incidence of cement leakage.
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Objective@#To compare the clinical outcomes of unilateral extreme extrapedicular puncture versus bilateral transpedicular puncture in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture.@*Methods@#A prospective cohort study was performed. Ninety-seven patients of osteoporotic vertebral compression fractures treated were selected from January 2016 to January 2018 in Beijing Friendship Hospital, Capital Medical University. There were 36 males and 61 females, aged (72.19±7.41) years, with an age range of 60-80 years. All the patients underwent PVP with different puncture methods were divided into unilateral puncture group(n=52) and bilateral puncture group(n=45). PVP was performed in the unilateral extreme extrapedicular puncture group by unilateral puncture of the pedicle, and PVP was performed by bilateral puncture of the pedicle in the bilateral transpedicular puncture group. All patients completed at least one year of follow-up after operation. The operation time, fluoroscopy times, cement volume, incidence of cement leakage, visual analogue score (VAS) of 1 week and 1 year after operation were observed. The measurement data were expressed as mean±standard deviation (Mean±SD), count data were expressed as percentage, the independent sample t test and the χ2 test were used for comparison between groups, and the paired t test was used for comparison within the group.@*Results@#The operation was successfully completed in both groups. No serious complications such as paraplegia, bone cement allergy, pulmonary embolism were occurred. In the unilateral puncture group, the operation time were (21.90±3.16) min, the fluoroscopy times were (15.46±2.86) times, the cement volume were (3.47±0.41) ml and the incidence of cement leakage was 44.23% (23/52), in the bilateral puncture group, the operation time were (31.64±6.90) min, the fluoroscopy times were (23.31±2.39) times, the cement volume were (4.66±0.61) ml and the incidence of cement leakage was 68.89% (31/45). The operation time, fluoroscopy times, cement volume and incidence of cement leakage of unilateral puncture group were significantly less than those of bilateral puncture group. The difference was statistically significant (P< 0.05). The VAS score in unilateral puncture group was (8.18±0.77) scores in preoperation, (3.39±0.69) scores in 1 week, (1.07±0.90) scores in 1 year. The VAS score in bilateral puncture group was (7.93±0.92) scores in preoperation, (3.14±0.83) scores in 1 week and (0.90±0.82) scores in 1 year. Compared with pre-operation, the VAS scores of the two groups decreased significantly at 1 week and 1 year after operation, and the difference was statistically significant (P<0.05). However, there was no significant difference in VAS between groups at 1 week after operation and 1 year after operation (P>0.05).@*Conclusions@#Compared with bilateral transpedicular puncture, PVP through unilateral extrapedicular puncture can achieve the same clinical effect. However, the latter can significantly reduce the operation time, the cement volume, fluoroscopy times and the incidence of cement leakage.