Effect of Endplate Fracture on Postoperative Outcome of Percutaneous Vertebroplasty
Objective To conduct a retrospective study evaluating the impact of endplate fracture(EF)on the safety and prognosis of percutaneous vertebroplasty(PVP)in patients diagnosed with osteoporotic vertebral compression fractures(OVCF).Methods A total of 138 patients with OVCF who underwent unilateral pedicle PVP at the Fifth People's Hospital of Wuhu from March 2021 to September 2022 were included in this study.The cohort consisted of 76 females and 62 males,with ages ranging from 65 to 85 years,and a mean age of(76.51±6.83)years.Vertebral fractures involved 47 thoracic and 91 lumbar vertebrae.Based on preoperative magnetic resonance imaging(MRI)findings,patients were categorized into two groups:An endplate fracture group(EF group,n=31)and a non-endplate fracture group(non-EF group,n=107).Various surgical and outcome metrics were recorded and analyzed,including operation time,bone cement injection volume,fluoroscopy frequency,hospital stay duration,Cobb angle measurements,incidences of bone cement leakage and vertebral re-fracture,as well as the visual analog scale(VAS)and Oswestry disability index(ODI)scores for low back pain assessment preoperatively,3 days postoperatively,and at 3 months follow-up.Results All patients were followed up for 3 to 4 months,with a mean follow-up duration of(3.16±0.25)months.At the final follow-up,a significantly higher number of adjacent vertebral fractures were observed in the EF group(7 cases)compared to the non-EF group(4 cases)(P＜0.01).Regarding bone cement leakage,14 cases were recorded in the non-EF group and 9 in the EF group,showing a statistically significant difference(P＜0.05).Notably,the EF group had significantly lower bone cement injection volumes than the non-EF group,accompanied by significantly higher fluoroscopy frequencies and operative times(P＜0.05).The VAS scores and ODI indices in the EF group were also significantly higher than those in the non-EF group(P＜0.01).At the last follow-up,the anterior vertebral height of the non-EF group was greater than the EF group,while the Cobb angle was smaller,the difference was statistically significant(P＜0.05).ConclusionEndplate fracture emerges as a key factor contributing to bone cement leakage,vertebral height loss,and adjacent vertebral re-fractures in patients undergoing PVP for OVCF.Thus,emphasis should be placed on the meticulous management of endplate fractures during PVP procedures to mitigate the risk of chronic low back pain and optimize surgical outcomes.
万方数据
维普
