Efficacy analysis of percutaneous vertebroplasty with high-viscosity bone cement for the treatment of osteoporotic vertebral compression fractures

English Keywords:Osteoporotic vertebral compression fracture  High-viscosity bone cement  Percutaneous vertebroplasty  Percutaneous kyphoplasty

English Abstract:

  【Abstract】 Objectives: To compare the clinical efficacy and imaging characteristics of percutaneous vertebroplasty(PVP) with high-viscosity bone cement and percutaneous kyphoplasty with low-viscosity bone cement for osteoporotic vertebral compression fractures(OVCF), and to estimate the clinical value of PVP with high-viscosity bone cement. Methods: 115 patients were diagnosed and treated with one-level OVCF in Peking University Shougang Hospital from June 2015 to December 2016. 65 patients were applied by PVP with high-viscosity bone cement(group A), and 50 patients were applied by percutaneous kyphoplasty(PKP) with low-viscosity bone cement(group B). The basic clinical information, VAS, ODI, operation time, intraoperative X-ray times, bone cement volume, bone cement leakage, bone cement distribution status, anterior vertebral height and kyphosis(Cobb angle) were collected. SPSS 20.0 was used for statistical analysis. Results: There were significant improvements of VAS, ODI, anterior vertebral height and Cobb angle from preoperatively to postoperatively(P<0.01), there was no significant difference of bone cement leakage between two groups, but the operation time and intraoperative fluoroscopy times of group A were significantly less than those of group B(P<0.01). In group A, there were 6 cases(9.2%) of unilateral diffusion of bone cement in CT, 12 cases(18.5%) of bilateral asymmetric diffusion, 47 cases(73.3%) of bilateral symmetrical diffusion; those three diffusion patterns of group B were 33 cases(66.0%), 7 cases(14.0%), 10 cases(20.0%), respectively; there was a significant difference between the two groups(P<0.01). In group A, there were 3 cases(4.6%) of no endplate diffusion, 16 cases(24.6%) of one endplate diffusion and 46 cases(71.0%) of both endplates diffusion; those of group B were 17 cases(34.0%), 22 cases(44.0%), 11 cases(22.0%), respectively; there was a significant difference between the two groups(P<0.01). Conclusions: PVP with high-viscosity bone cement has a good short-term clinical efficacy. It leads to bone cement symmetrical diffusion to the vertebral anterior column and vertebral endplates, which restores the height of vertebral body, improves the kyphosis and reduces the risk of refracture. But the risk of bone cement leakage of this procedure is comparable to that of PKP with low viscosity bone cement.