A flexible vertebroplasty device used in vertebroplasty for osteoporotic thoracic compression fractures / 中华创伤骨科杂志

ABSTRACT

Objective To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery,Xi'an Honghui Hospital from June 2016 to January 2017.They were 61 males and 79 females,aged from 55 to 88 years (average,70.3 years).Their fractured vertebrae distributed from T5 to T12.Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B).The 2 groups were compared in terms of operative time,amount of bone cement injected,distribution ratio of bone cement on the contralateral side,bone cement leakage,and visual analogue scale (VAS),anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d,1 and 2 years after operation.Results The 2 groups were comparable due to their insignificant differences in preoperative general data (P ＞ 0.05).All the patients were followed up for more than 2 years,with an average of 26.7 months.There were no significant differences between the 2 groups in operation time (28.1 ±4.2 min versus 26.3 ±3.2 min) or in bone cement leakage [34.3％ (23/67) versus 17.8％ (13/73)] (P ＞ 0.05).However,group A was significantly higher than group B in amount of bone cement injection (5.6 ± 1.2 mL versus 4.9 ± 1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5％ ± 11.3％ versus 65.7％ ± 12.9％),significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1 ±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°),and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2％ ± 8.1％ and 37.1％ ± 7.2％ versus 35.4％ ± 7.8％ and 33.2％ ± 8.4％) (all P ＜0.05).There were no significant differences between the 2 groups in VAS,anterior height ratio of the fractured vertebra or kyphosis cobb angle at one day after operation (P ＞ 0.05).Conclusions Compared with the conventional straight bone cement injector,our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement,more effective maintenance of the height of injured vertebra,and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures.