2022, Vol. 26 ›› Issue (28): 4494-4499

Percutaneous kyphoplasty and percutaneous vertebroplasty for osteoporotic vertebral compression fractures: relationship of bone cement leakage with postoperative pain, Cobb angle of injured vertebrae, and gait recovery

Li Youwen, Zheng Xingping, Zeng Jianhong, Chen Yu   

Abstract: BACKGROUND: Percutaneous vertebroplasty and percutaneous kyphoplasty are safe and effective surgical options for the treatment of osteoporotic vertebral compression fractures. Both have their advantages and disadvantages.
OBJECTIVE: To explore the effect of percutaneous kyphoplasty and vertebroplasty on the early and mid-term gait of patients with osteoporotic vertebral compression fractures.
METHODS: A total of 115 patients with osteoporotic vertebral compression fractures who were admitted to the Department of Spine Surgery, People’s Hospital of Dongxing District in Neijiang City from March 2018 to July 2020 were divided into two groups using a random number table. Percutaneous kyphoplasty bone cement injection treatment was conducted in 63 cases and percutaneous vertebroplasty bone cement injection treatment was performed in 52 cases. The amount of bone cement in the fractured vertebrae and the leakage of bone cement were recorded during the operation. X-ray examinations were performed before and 12 weeks after the operation. Cobb angle of the injured vertebrae was measured. The two groups of patients were tested for gait and pain assessment before, 6, and 12 weeks after the operation. Visual analogue scale score was used for pain assessment. The study was approved by the Research Ethics Committee of the People’s Hospital of Dongxing District, Neijiang City.
RESULTS AND CONCLUSION: (1) The amount of bone cement in the kyphoplasty group was more than that in the vertebroplasty group (P < 0.05), and the leakage rate of bone cement was lower than that in the vertebroplasty group (12.7%, 28.8%, P < 0.05). (2) In comparison with preoperative data, the Cobb angle of the injured vertebrae in the kyphoplasty group decreased at 12 weeks (P < 0.05), but there was no significant change in the vertebroplasty group
(P > 0.05). The Cobb angle of the injured vertebrae in the kyphoplasty group was lower than that of the vertebroplasty group (P < 0.05). (3) The postoperative pain and walking movement function of the two groups were significantly improved, and the pain condition and walking movement function of the kyphoplasty group were better than those of the vertebroplasty group at 6 weeks after surgery (P < 0.05). There was no significant difference in pain condition and walking movement function between the two groups at 12 weeks after surgery (P > 0.05). (4) At 12 weeks postoperatively, there was no significant difference in postoperative pain, Cobb angle and gait parameters between the cement leakage group and the non-cement leakage group (P > 0.05). (5) The results have shown that compared with percutaneous vertebroplasty, percutaneous kyphoplasty can restore the walking movement function of patients with osteoporotic vertebral compression fractures earlier, with better fracture reduction and analgesic effects, less bone cement leakage.
Key words: bone cement, percutaneous kyphoplasty, percutaneous vertebroplasty, osteoporotic, vertebral compression fractures, gait analysis