Comparison of efficacy of vertebroplasty via extra-pedicular lateral approach versus pedicular approach for osteoporotic thoracolumbar compression fractures
Objective To compare the efficacy and the incidence of postoperative residual lower back pain between the extra-pedicular lateral approach and the pedicular approach in percutaneous vertebroplasty for osteoporotic thoracolumbar compres-sion fractures.Methods Fifty-eight patients with newly diagnosed single-segment osteoporotic thoracolumbar compression fractures treated with percutaneous vertebroplasty from March 2019 to May 2020 were included.Twenty-nine patients under-went the procedure via the extra-pedicular lateral approach(extra-pedicular lateral approach group)while another 29 via the pedicular approach(pedicular approach group).The two groups were compared in terms of operation time,volume of bone ce-ment injected,bone cement leakage rate,postoperative pain VAS(Visual Analog Scale)scores,incidence of postoperative short-term residual lower back pain,and postoperative vertebral kyphotic angle.Results There was no significant difference in op-eration time and bone cement leakage rate between the two groups(P＞0.05).However,the volume of bone cement injected in the extra-pedicular lateral approach group was significantly higher than that in the pedicular approach group(P＜0.05).All pa-tients were followed up for 3 to 12 months,with an average of 6.5 months.Postoperative pain was significantly relieved in both groups.The extra-pedicular lateral approach group had significantly lower postoperative day 1 and week 1 pain VAS scores compared to the pedicular approach group(P＜0.05).The postoperative vertebral kyphotic angle was significantly improved com-pared to preoperative values in both groups,but there was no significant difference between the two groups(P＞0.05).Both groups experienced short-term postoperative residual lower back pain,with the pedicular approach group showing a higher inci-dence of residual lower back pain on postoperative day 1 and week 1 compared to the extra-pedicular lateral approach group(P＜0.05).There was no significant difference in the incidence of residual lower back pain at 1 month postoperatively between the two groups(P＞0.05).Conclusion Both the extra-pedicular lateral approach and the pedicular approach for vertebroplasty in treating osteoporotic thoracolumbar compression fractures can achieve satisfactory outcomes.However,the incidence of short-term postoperative residual lower back pain is significantly lower in the extra-pedicular lateral approach compared to the pe-dicular approach.
NETL
NSTL
万方数据
