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BACKGROUND: Percutaneous vertebroplasty has been extensively applied In the treatment of senile osteoporotic vertebral compression fracture with pain. However, the appropriate dose of bone cement remains controversial. OBJECTIVE: To compare the efficacy and complications of different viscosities of high-dose bone cement applied In the treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty. METHODS: One hundred and sixty-nine patients with single-segment osteoporotic fractures at thoracolumbar level (T12-L2) admitted at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from February 2014 to December 2018 were Included. All patients were treated by percutaneous vertebroplasty with high-dose (> 4 mL) bone cement at low viscosity (n=85, control group) and high viscosity (n=84, observation group). The Visual Analogue Scale score, anterior vertebral height, Cobb angle and bone cement leakage were recorded before and 2 days after surgery. The study was approved by the Medical Ethics Committee of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, China (approval No. SH9H-2019-T90-1). RESULTS AND CONCLUSION: (1) The Visual Analogue Scale score at postoperative 2 days in both groups were significantly lower than that at baseline (P 0.05). (2) The anterior vertebral height at postoperative 2 days in both groups was significantly higher than that at baseline (P 0.05). (3) Compared with the baseline level, the Cobb angle at postoperative 2 days in both groups was significantly decreased (P 0.05). (4) The incidence of bone cement leakage in the observation group (36/84,42.9%) was significantly lower than that in the control group (57/85, 67.1 %) (P < 0.05). The incidence of leakage In paravertebral vessels and spinal canal in the observation group was significantly lower than that in the control group (P < 0.05). (5) Peri-Implant Infection, allergic reaction, Immune and rejection reactions occurred in neither groups. (6) These results Indicate that treatment of senile osteoporotic vertebral compression fractures with high dose of low- and high-viscosity bone cement can result In good clinical outcomes. However, the Incidence of leakage is higher in the low-viscosity bone cement, and high-viscosity bone cement can significantly reduce the risk of leakage, especially the leakage of paravertebral blood vessels and spinal canal.
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Objective To discuss the advantages of postoperative early ambulation for patients after high-viscosity bone cement injection treatment for osteoporotic vertebral compression fracture.Methods A total of 42 patients with osteoporotic vertebral compression fracture were divided into the study group (n=21)and the control group (n=21).High-viscosity bone cement injection was used to perform percutaneous vertebroplasty for the patients in the study group,while low-viscosity bone cement injection was adopted to complete percutaneous vertebroplasty for the patients in the control group.The patients of the study group were asked to get out of bed in 4 hours after vertebroplasty and to do off-bed activity in 8 hours after vertebroplasty,while the patients of the control group were asked to get out of bed in 12 hours after vertebroplasty and to do off-bed activity in 24 hours after vertebroplasty.CT reexamination was performed within 3 days after vertebroplasty to observe the paravertebral leakage and the cement distribution in vertebrae.The visual analogue scale (VAS),the ability score of daily life activy (Barthel),the risk score of pressure skin ulcer (Braden) and the risk rating of deep venous thrombosis were used to evaluate the clinical effectiveness for both groups.Results The procedure of vertebroplasty was successfully accomplished in all patients of both groups.No statistically significant differences in VAS score and in Barthel score at 24 hours and 7 days after vertebroplasty existed between the two groups (P＞0.05).Eight days after vertebroplasty,the differences in Barthel score,Braden score and the risk rating of deep venous thrombosis between the two groups were statistically significant (P＜0.05),although the difference in VAS score between the two groups was not statistically significant.Conclusion In treating osteoporotic vertebral compression fracture by using high-viscosity bone cement injection,postoperative early ambulation can effectively improve the patient's daily activities,reduce the risk of the formation of pressure skin ulcer and deep vein thrombosis,thus,reduce the nursing workload for both nurses and patient's family members.(J Intervent Radiol,2017,26:749-752).