ABSTRACT
Objective To investigate the effect of a modified puncture cannula on prevention of bone cement leakage in percutaneous vertebroplasty (PVP).Methods From January 2014 to February 2018,243 patients with single-segmental osteoporotic vertebral fracture were treated with PVP at Department of Orthopedics,Shanghai Ninth People's Hospital.Their clinical data were retrospectively analyzed.Of them,a common puncture cannula was used in 169 cases (control group) and a modified puncture cannula in 74 (modified group).In the control group,there were 41 men and 128 women with an age of 71.6 ± 9.5 years,and the fracture was distributed from T5 to T10 in 7 cases,from T11 to L2 in 132 and from L3 to L5 in 30.In the modified group,there were 20 men and 54 women with an age of 73.6 ± 9.3 years,and the fracture was distributed from T5 to T10 in 3 cases,from T11 to L2 in 63 and from L3 to L5 in 8.The 2 groups were compared in terms of postoperative recovery of vertebral height,reduction in visual analogue scale (VAS) and bone cement leakage.Results There were no significant differences between the 2 groups in age,gender,distribution of fractured vertebral bodies,compression degree,condition of vertebral posterior wall,or bone cement volume injected (P ＞ 0.05).There were no significant differences either between the control and modified groups in the postoperative recovery of vertebral height (7.43％ ± 7.82％ versus 6.20％ ±7.84％) or reduction in VAS score (5.83 ± 0.99 versus 5.81 ± 0.89) (P ＞ 0.05).Bone cement leakage occurred in 93 cases (55.0％) in the control group but in 26 cases (35.1％) in the modified group,showing a significant difference (P ＜ 0.05).The incidences of bone cement leakage in the paravertebral vessels [13.5％(10/74)],paravertebral soft tissue [9.5％ (7/74)] and spinal canal [4.1％ (3/74)] in the modified group were all significantly lower than those in the control group [25.4％ (43/169),20.1％ (34/169) and 15.4％ (26/169)] (P ＜ 0.05).Conclusion Application of the modified end-to-side puncture cannula is an optional scheme to prevent bone cement leakage in PVP,because it can reduce the incidence of bone cement leakage without compromising postoperative short-term outcomes,especially in the spinal canal,paraspinal vessels and paraspinal soft tissue.
ABSTRACT
Objective@#To investigate the effect of a modified puncture cannula on prevention of bone cement leakage in percutaneous vertebroplasty (PVP).@*Methods@#From January 2014 to February 2018, 243 patients with single-segmental osteoporotic vertebral fracture were treated with PVP at Department of Orthopedics, Shanghai Ninth People's Hospital. Their clinical data were retrospectively analyzed. Of them, a common puncture cannula was used in 169 cases (control group) and a modified puncture cannula in 74 (modified group). In the control group, there were 41 men and 128 women with an age of 71.6±9.5 years, and the fracture was distributed from T5 to T10 in 7 cases, from T11 to L2 in 132 and from L3 to L5 in 30. In the modified group, there were 20 men and 54 women with an age of 73.6±9.3 years, and the fracture was distributed from T5 to T10 in 3 cases, from T11 to L2 in 63 and from L3 to L5 in 8. The 2 groups were compared in terms of postoperative recovery of vertebral height, reduction in visual analogue scale(VAS) and bone cement leakage.@*Results@#There were no significant differences between the 2 groups in age, gender, distribution of fractured vertebral bodies, compression degree, condition of vertebral posterior wall, or bone cement volume injected (P>0.05). There were no significant differences either between the control and modified groups in the postoperative recovery of vertebral height (7.43%±7.82% versus 6.20%±7.84%) or reduction in VAS score (5.83±0.99 versus 5.81±0.89) (P>0.05). Bone cement leakage occurred in 93 cases (55.0%) in the control group but in 26 cases (35.1%) in the modified group, showing a significant difference (P<0.05). The incidences of bone cement leakage in the paravertebral vessels [13.5% (10/74)], paravertebral soft tissue [9.5%(7/74)] and spinal canal [4.1%(3/74)] in the modified group were all significantly lower than those in the control group [25.4%(43/169), 20.1%(34/169) and 15.4%(26/169)](P<0.05).@*Conclusion@#Application of the modified end-to-side puncture cannula is an optional scheme to prevent bone cement leakage in PVP, because it can reduce the incidence of bone cement leakage without compromising postoperative short-term outcomes, especially in the spinal canal, paraspinal vessels and paraspinal soft tissue.
