Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, Guangdong, China.
Department of Orthopedic, The First Affiliated Hospital of Xinxiang Medical University, No. 88, Jiankang Road, Weihui, 453100, Henan, China.
J Orthop Surg Res. 2021 Jan 21;16(1):73. doi: 10.1186/s13018-021-02219-6.
Percutaneous vertebroplasty (PVP) is a routine operation for the treatment of osteoporotic lumbar compression fractures (OLCFs). As is well known, unilateral puncture is a common method. However, with the conventional transpedicular approach (CTPA), the cement may be asymmetrically dispersed, so some surgeons use the transverse process root-pedicle approach (TPRPA). The objective of this study was to compare the clinical results and bone cement distribution of PVP for OLCF with unilateral TPRPA and CTPA to identify the advantages and disadvantages of the two surgical options.
From January 2016 to June 2019, seventy-two elderly patients who underwent unilateral PVP for single-level OLCF were retrospectively reviewed. Operation time, injection amount and type of bone cement distribution, and bone cement leakage and surgical complications were recorded. The visual analog scale (VAS) scores and Oswestry disability index (ODI) scores were used to evaluate the clinical results. All patients were followed up for more than 12 months, and the assessment was based primarily on clinical and radiological outcomes.
There were significant differences in the surgical time and the volume and the type of bone cement distribution and the lost of operative vertebra height between the two groups. However, there was no significant difference in bone cement leakage. Moreover, there were no significant differences in VAS and ODI between the two groups at 2 days and 12 months after the operation.
Unilateral TPRPA and CTPA are practical and feasible methods in PVP for the treatment of OLCF, and they have similar clinical effects. However, TPRPA has the advantages of a better distribution of bone cement and a shorter operation time and a better maintenance effect of injured vertebra height, without increasing the rate of bone cement leakage.
经皮椎体成形术（PVP）是治疗骨质疏松性胸腰椎压缩性骨折（OLCF）的常规手术。众所周知，单侧穿刺是一种常见的方法。然而，采用传统经皮椎弓根入路（CTPA）时，骨水泥可能会不对称分布，因此一些外科医生采用横突根-椎弓根入路（TPRPA）。本研究旨在比较单侧 TPRPA 和 CTPA 治疗 OLCF 的 PVP 的临床结果和骨水泥分布，以确定两种手术选择的优缺点。
回顾性分析 2016 年 1 月至 2019 年 6 月期间采用单侧 PVP 治疗单节段 OLCF 的 72 例老年患者。记录手术时间、注射量和骨水泥分布类型，以及骨水泥渗漏和手术并发症。采用视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评分评估临床结果。所有患者均随访 12 个月以上，主要根据临床和影像学结果进行评估。
两组在手术时间、骨水泥分布量和类型以及手术椎体高度丢失方面存在显著差异。但是，骨水泥渗漏率无显著差异。此外，两组患者术后 2 天和 12 个月时 VAS 和 ODI 评分无显著差异。
单侧 TPRPA 和 CTPA 是治疗 OLCF 的 PVP 实用且可行的方法，它们具有相似的临床效果。然而，TPRPA 具有更好的骨水泥分布、更短的手术时间和更好的受伤椎体高度维持效果的优点，同时不会增加骨水泥渗漏的发生率。
