Clinical outcomes of oblique-opening cannula in percutaneous vertebroplasty for osteoporotic vertebral compression fracture
Objective:To compare the clinical outcomes of oblique-opening cannula with traditional flat-opening cannula during percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture(OVCF).Methods:A retrospective analysis was conducted on the clinical data from 189 OVCF patients who underwent PVP from January 2020 to June 2022 in Beijing Luhe Hospital,Capital Medical University.Among them,95 patients were treated with an oblique-opening cannula(oblique-opening cannula group),and 94 patients were treated with a flat-opening cannula(flat-opening cannula group).Postoperative computed tomography scans were performed on the first day to observe bone cement leakage and dispersion within the vertebrae in both groups.The operation time,bone cement volume,length of hospital stay,and visual analog scale(VAS)pain scores before surgery,one day post-surgery,and six months post-surgery were compared between the two groups.Multinomial logistic regression analysis was conducted to identify factors affecting bone cement leakage.Results:The oblique-opening cannula group showed significantly lower rates of cortical(13.7%[13/95])and venous(12.6%[12/95])bone cement leakage compared to the flat-opening cannula group(24.5%[23/94]and 51.5%[48/94],respectively;both P<0.05).The dispersion of bone cement in the oblique-opening cannula group(82.1%[78/95])was also superior compared to the flat-opening cannula group(69.1%[65/94];P<0.05).The operation time in the oblique-opening cannula group was shorter than that in the flat-opening cannula group(P<0.05).There were no statistically significant differences in bone cement volume,length of hospital stay,and VAS score at the specified times between the two groups(all P>0.05).Multinomial logistic regression analysis identified that the use of oblique-opening cannula(odds ratio[OR]=0.173,95%confidence interval[95%CI]:0.068-0.439,P=0.000)and mild-fracture(OR=0.176,95%CI:0.066-0.475,P=0.001)were protective factors against cortical leakage of bone cement,while cortical bone rupture(OR=5.294,95%CI:1.094-25.617,P=0.038)was an independent risk factor.The use of oblique-opening cannula(OR=0.068,95%CI:0.029-0.159,P=0.000)was a protective factor against venous leakage of bone cement,whereas male gender(OR=2.701,95%CI:1.071-6.817,P=0.035)was an independent risk factor.Conclusions:The use of oblique-opening cannula in PVP for OVCF can effectively reduce the incidence of bone cement leakage and achieve better dispersion of bone cement.
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