Percutaneous vertebroplasty in treatment of upper thoracic osteoporotic compression fracture / 中华创伤杂志

ABSTRACT

Objective To evaluate the feasibility, safety and efficacy of percutaneous vertebroplasty (PVP) for osteoporotic compression fracture of the upper thoracic spine.Methods The study enrolled 20 patients with osteoporotic compression fracture in 25 upper thoracic segments.The subjects (5 males and 15 females) aged at (71.0 ± 10.8) years (range, 57-89 years).Fracture occurred in 2 T1, 3 T2,5 T3 and 15 T4 segments.The subjects were submitted to puncture process via unilateral extrapedicular approach.Operation time, volume of infused bone cement, X-ray images and CT scan were recorded after operation.Visual analogue score (VAS), mobility score and Oswestry disability index (ODI) were assessed after operation.Results The procedure was successfully accomplished in all patients.Mean operation time was (39.7 ± 10.6)min.Infusion volume of bone cement was 2.0-6.0 ml [(3.3 ± 1.5)ml].Eighteen patients were available to the follow-up of 5.5-18 months [(7.6 ± 2.7) months].Three patients (15％) were associated with cement leakage into the epidural (n =1), paravertebral soft tissues (n =1) and disc (n =1) but remained asymptomatic.One patient (5％) had new fracture at the non-adjacent and non-operative segments within 15 days, and had no recurrence after PVP.No other serious complications such as rib fracture, pneumothorax, pulmonary embolism, vascular injury, spinal injury and infection were found.VAS, mobility score and ODI improved at 3 d, 1 month, 3 months and final follow-up compared to those at 1 d pre-operation (P ＜0.O1).Conclusions PVP is a safe and effective treatment for upper thoracic osteoporotic compression fracture, which is associated with few complications,reduced pain and improved mobility as well as quality of life.Rational surgical position and puncture approach are beneficial to a successful surgery.