Effect of bone cement dispersion height in percutaneous kyphoplasty and percutaneous vertebroplasty on the surgical outcomes for osteoporotic vertebral compression fractures
Objective:To explore the effect of bone cement dispersion height on the surgical efficacy of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF). Methods:The clinical data of 115 patients with osteoporotic T11-L2 spinal fractures admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from May 2023 to March 2024,were retrospectively analyzed. Patients were divided into the PKP group (n=60) and the PVP group (n=55) according to surgical method. The preoperative and postoperative visual analog scale (VAS) scores,Oswestry Disability Index (ODI),kyphosis angle (Cobb angle),postoperative bone cement leakage,and the incidence of adjacent vertebral fractures were analyzed between the two groups. The postoperative bone cement dispersion height and its proportion in vertebral body were also compared between the two groups. Results:All patients successfully underwent surgery. Compared with the PVP group,the PKP group had significantly longer surgery times,more intraoperative fluoroscopy sessions,and more bone cement usage (all P<0.05). The VAS scores of both groups decreased significantly at 1 day and 3 months postoperatively compared to preoperative levels (all P<0.05),with the PKP group showing significantly lower VAS scores than the PVP group at both time points (all P<0.05). The ODI scores of both groups were significantly reduced at 6 months postoperatively compared to preoperative levels (all P<0.05),with the PKP group exhibiting significantly lower ODI scores than the PVP group (P<0.05). The incidence of postoperative bone cement leakage in the PKP group was 3.33％ (2/60),which was significantly lower than that in the PVP group (14.44％,8/55) (P<0.05). The incidence of adjacent vertebral fractures after surgery in the PKP group was 5.00％ (3/60),which was slightly lower than that in the PVP group (10.91％,6/55) (P>0.05). The PKP group had significantly higher anterior column height,bone cement height of the anterior column,middle column height,bone cement height of the middle column,vertebral body height,and maximum bone cement height than those in the PVP group (all P<0.05). The proportion of bone cement dispersion height of anterior column (r=-0.721,P<0.05;r=-0.703,P<0.05) and the maximum bone cement dispersion height (r=-0.584,P<0.05;r=-0.467,P<0.05) were significantly negatively correlated with ODI score at 6 months postoperatively in both groups,while the proportion of bone cement dispersion height of the middle column showed no significant correlation with ODI score at 6 months postoperatively (r=-0.088,P>0.05;r=-0.023,P>0.05). Conclusions:Both PKP and PVP can significantly improve pain symptoms and alleviate functional impairment in OVCF patients. The advantages of PVP include a shorter surgery time,fewer intraoperative fluoroscopy sessions,and a less bone cement usage. The advantages of PKP include better recovery of vertebral height a lower risk of postoperative bone cement leakage,and better recovery in pain and functional impairment. The bone cement dispersion height and its proportion in the vertebral body can serve as reference indicators for predicting the surgical outcomes of PVP and PKP.
万方数据
维普
