[APPLICATION OF HIGH VISCOSITY BONE CEMENT IN UNILATERAL PUNCTURE PERCUTANEOUS VERTEBROPLASTY FOR TREATMENT OF FRESH VERTEBRAL FRACTURE].

OBJECTIVE

To discuss the effectiveness of high viscosity bone cement in unilateral puncture percutaneous vertebroplasty (PVP) for the treatment of osteoporotic fresh vertebral fracture and operation skills of the bone cement leakage prevention.

METHODS

Between November 2005 and October 2013, 82 elderly patients with fresh thoracolumbar vertebral fracture were first treated with hyperextension postural reduction and then with high viscosity bone cement in unilateral pedicle puncture PVP. Of 82 cases, 25 were male and 57 were female with an average age of 72.3 years (range, 61-90 years). The causes included falling injury in 28 cases, sprain injury in 11 cases, car shock injury in 4 cases, fracture by cough or sneeze in 6 cases, and no obvious reason in 33 cases. The time from injury to operation was 3-15 days (mean, 7.6 days). Single segment was involved in 74 cases, and double segments in 8 cases. The operation time, fluoroscopy time, intraoperative blood loss, and hospitalization time were recorded, bone cement leakage was observed; pain visual analogue scale (VAS) was used to evaluate pain relief effect; X-ray films were taken for measurement of the Cobb angle and anterior vertebral body height compression ratio to evaluate the correction effect.

RESULTS

The average operation time was 16 minutes; the average fluoroscopy time was 48 seconds; the average hospitalization time was 3 days. All cases were followed up from 6 to 18 months (mean, 6.8 months). Leakage of bone cement occurred in 6 cases (7.3%), including 3 cases of paravertebral soft tissue leakage, 1 case of intervertebral disc leakage, and 2 cases of venous leakage. There was no nerve damage or paralysis. At last follow-up, VAS score was significantly decreased to 1.3 ± 0.9 from preoperative 8.8 ± 1.2 (t = 73.891, P = 0.000); Cobb angle was significantly reduced to (25.06 ± 6.18)° from preoperative (34.79 ± 7.18)° (t = 18.878, P = 0.000); and the anterior vertebral body height compression ratio was significantly increased to 67.8% ± 5.7% from preoperative 41.3% ± 9.8% (t = 36.880, P =0.000).

CONCLUSION

Application of high viscosity bone cement in unilateral puncture PVP can shorten operation time, reduce bone cement leakage rate, and achieve satisfactory effectiveness.