Effects of targeted puncture technique on surgical outcomes and bone cement distribution in the treatment of thoracolumbar compression fractures by percutaneous vertebroplasty
Objective To explore the role of targeted puncture technique in percutaneous vertebroplasty(PVP)for the treatment of osteoporotic thoracolumbar compression fractures,and to analyze its impact on surgical outcomes and the distribution of bone cement in the injured vertebral body.Methods A retrospective analysis was conducted on 113 patients with osteoporotic thoracolumbar compression fractures treated by PVP in the department of orthopedics,Shunyi Hospital,Beijing from Jan.2020 to Mar.2022,including 39 males and 74 females aged 63-75 years,mean 68.1 years.There were 11 cases of falls from heights,39 road traffic injuries and 63 ground-level falls.According to the puncture pathways,58 patients were divided into the targeted puncture group and 55 into the con-ventional puncture group.The surgical time,amount of bone cement,leakage of bone cement,distribution of bone ce-ment in the injured vertebra,VAS score and the posterior convex angle(Cobb angle)of the injured vertebra before and 1 d and 3 months after surgery were calculated for both groups of patients.Results Compared to that before surgery,the VAS score showed a significant decrease at 1 d after surgery in both targeted puncture group(2.6±0.3 vs.8.9±0.5)and conventional puncture group(2.8±0.4 vs.8.7±0.6,both P＜0.05),but no statistically signifi-cant difference between the two groups(P＞0.05),and moreover much lower VAS score in the targeted puncture group at 3 months after surgery(0.9±0.2 vs.2.4±0.3,P＜0.05).There was no statistically significant difference between the two groups in terms of surgical time,amount of bone cement,and bone cement leakage(P＞0.05),but the targeted puncture group was superior to the conventional puncture group in the distribution of bone cement in the injured vertebral body,with statistically significant difference(P＜0.05).The Cobb angle of the injured vertebrae revealed no statistically significant difference between the two groups before and 1 d after surgery(P＞0.05),but was much smaller at 3 months after surgery in the targeted puncture group(15.1°±1.6° vs.21.2°±2.0°,P＜0.05).Conclusion In the treatment of osteoporotic thoracolumbar compression fractures by PVP,the application of targeted puncture technique can help improve the distribution of cement in the injured vertebrae,and shows advan-tages in maintaining vertebral height and reducing pain,which is worthy of clinical promotion.
万方数据
维普
