Comparison between curved and unipedicular approach vertebroplasty for treatment of osteoporotic vertebral compression fractures / 中华创伤杂志

ABSTRACT

Objective To evaluate the safety and effectiveness of a curved vertebroplasty (CVP) compared with traditional unipedicular approach vertebroplasty (UVP) in treating osteoporotic vertebral compression fractures (OVCF).Methods This was a retrospective case control study on the clinical data of 77 OVCF patients (12 males,65 females;aged 55-86 years,mean 70.8 years) admitted between July 2013 and December 2016.There were 6 injured vertebrae at T1 10,73 at T11 L2,and 12 at L3 5.The patients were divided into CVP group (36 patients,44 vertebrae) and UVP group (41 patients,47 vertebrae) with no significant difference in baseline clinical variables.Intraoperative and postoperative complications including neurovascular injury were recorded.Operation duration,fluoroscopy frequency,volume of cement per level,cement leakage rate per level treated,cement distribution,and refracture rate were compared between the two groups.Preoperative and postoperative visual analog scale (VAS) and Oswestry disability index (ODI) were compared both within the group and between the groups.Results No severe complications related to puncture were observed.No significant difference was observed for operation duration,fluoroscopy frequency,and cement leakage rate per level treated between the two groups (P ＞ 0.05).Compared with UVP group,CVP group had larger volume of cement per level [(5.0 ± 1.4) ml vs.(4.3 ± 1.6) ml],more uniform cement distribution (none vs.10 cases),and lower refracture rate (0 vs.10％) (P ＜ 0.05).The two groups were followed up for 6-49 months (mean,25.9 months).Significant improvements on the VAS and ODI were noted within each group (P ＜0.01),but there was no significant difference between the two groups (P ＞ 0.05).Conclusions Both CVP and UVP are safe and effective treatments for OVCF.Compared with UVP,CVP entails more uniform cement distribution and lower refracture rate.