Vertebral height restoration and its associative factors during high-viscosity bone cement vertebroplasty in the treatment of osteopomsis vertebral compression fractures

English Keywords:Osteopomsis vertebral compression fracture  Vertebroplasty  Bone cement  Correlation

English Abstract:

  【Abstract】 Objectives: To investigate the vertebral height restoration and its associative factors during high-viscosity bone cement vertebroplasty in the treatment of osteopomsis vertebral compression fractures(OVCF). Methods: 96 cases using high-viscosity bone cement during vertebroplasty were selected in our hospital from January 2015 to December 2016. There were 44 males and 52 females, aged 56-79 years old, with an average age of 67.36±5.36 years. Thoracic vertebrae were involved in 41 cases and lumbar vertebrae in 55 cases; 47 cases had single segment involved and 49 cases had double segments. According to the injection volume of bone cement, those with injection volume ≤4ml were classified as group A1(n=41), injection volume >4ml as group A2(n=55); according to the distribution of bone cement, the cases with filling rate ≤15% was classified as group B1(n=37), filling rate >15% as group B2(n=59). The anterior vertebral heights before operation and at 3 days after operation were compared among the four groups and the correlations of anterior vertebral height restoration with bone cement injection volume and diffusion degree were analyzed by linear regression analysis. Results: The anterior vertebral height at 3 days after operation in group A1 was higher than the preoperative one(P<0.05), and the central vertebral height showed no significant difference compared with the preoperative one(P>0.05); the postoperative anterior vertebral height and central vertebral height in group A2 were significantly higher than the preoperative ones(P<0.05), and those levels of group A2 were higher than those of group A1(P<0.05). The postoperative anterior vertebral height and central vertebral height in the group B1 showed no significant difference compared with the preoperative ones(P>0.05), and the postoperative anterior vertebral height and central vertebral height in group B2 were significantly higher than those before operation(both P<0.05), and those levels of group B2 were higher than those of group B1(P<0.05). The vertebral height restoration was closely related to the bone cement injection volume(r=0.63) and dispersion degree(r=0.65)(P<0.01). After 3 months of follow-up, the incidence rate of bone cement leakage in group A2 accounted for 1.82%(1/55), which was slightly lower than that of group A1 of 4.88%(2/41), but there was no statistical significance(χ2=0.47, P>0.05); the incidence of cement leakage in group B2 was 1.69%(1/59), which was slightly lower than that of group B1 of 5.41%(2/37), which showed no statistically significant difference(χ2=0.58, P>0.05). Conclusions: The high-viscosity bone cement appropriately increases the bone cement injection volume and dispersion degree which can effectively improve the vertebral height in patients with compression fractures.