2025, Vol. 29 ›› Issue (28): 5977-5984

Bone cement injection during percutaneous curved vertebroplasty in treatment of osteoporotic vertebral compression fractures in the upper 1/3 of the vertebral body

Li Tangbo, Zhang Nan, Hao Guobing, Liu Kun, Qiao Lin, Zhu Zexing, Song Diyu   

Abstract: BACKGROUND: Percutaneous curved vertebroplasty has the advantages of minimal trauma and bone cement dispersion, but whether it is safe and effective for the treatment of compression fractures in the upper 1/3 of the vertebral body needs further study.
OBJECTIVE: To investigate the clinical efficacy of percutaneous curved vertebroplasty in the treatment of the upper 1/3 compression fractures of the osteoporotic vertebrae.
METHODS: Medical records of 66 patients with osteoporotic thoracolumbar upper 1/3 compression fracture admitted to Department of Orthopedics of PLA Rocket Force Characteristic Medical Center from January 2020 to June 2023 were retrospectively analyzed. Among them, 32 cases were treated with percutaneous curved vertebroplasty (observation group) and 34 cases were treated with “noncoplanar bipedicular puncture” percutaneous vertebroplasty (control group). Pain visual analog scale score, Oswestry Disability Index, anterior edge height of injured vertebra, and Cobb angle of injured vertebra were compared and analyzed between the two groups before surgery, the first day after surgery, and the last follow-up. The operative time, bone cement leakage rate, bone cement injection volume, and bone cement dispersion score of the two groups were statistically analyzed.
RESULTS AND CONCLUSION: (1) The operations were successfully completed in both groups of patients, and no complications such as bone cement allergy, bone cement embolism, nerve damage, or epidural hematoma occurred. (2) Pain visual analog scale score, Oswestry disability index, anterior edge height, and Cobb angle of injured vertebra of the two groups at the first day after surgery and the last follow-up were all better than those before surgery, with statistically significant difference (P < 0.05), but there was no statistical significance between the two groups (P > 0.05). The Oswestry disability index of the two groups at the last follow-up was better than that on the first day after surgery (P < 0.05). (3) The operation time and bone cement leakage rate of the observation group were lower than those of the control group, and the differences were statistically significant (P < 0.05). (4) There were no significant differences in bone cement injection volume and bone cement dispersion score between the two groups (P > 0.05). (5) The results show that percutaneous curved vertebroplasty in the treatment of osteoporotic vertebrae compression fractures in the upper 1/3 of the vertebral body can effectively relieve pain, maintain vertebral height, and reduce operative time and bone cement leakage rate.

Key words: percutaneous curved vertebroplasty, percutaneous vertebroplasty, osteoporotic vertebral compression fracture, compression fracture of upper 1/3 vertebra, bone cement, efficacy