Department of Orthopedics, The 904Th Hospital of PLA, Wuxi Clinical College of Anhui Medical University, 101 Xing Yuan Rd, Wuxi, 214044, China.
Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
J Orthop Surg Res. 2023 Jan 11;18(1):32. doi: 10.1186/s13018-023-03506-0.
Percutaneous kyphoplasty (PKP) has been demonstrated to be effective in the treatment of osteoporotic vertebral compression fractures (OVCF). However, bilateral puncture techniques take more time to accept more X-ray radiation; some spinal surgeons apply unilateral puncture PKP, but the cement cannot be symmetrically distributed in the vertebral body, so we apply a directional bone cement delivery device that undergoes PKP through the unilateral pedicle puncture. This research aims to compare the clinical and radiological results of PKP via unilateral pedicle approach using a traditional bone cement delivery device and a directional bone cement delivery device and determine the value of a directional delivery device for the therapy of thoracolumbar compression fracture in the elderly.
We undertook a retrospective analysis of patients with single-level OVCF treated with unilateral pedicle puncture PKP from Jan 2018 to Jan 2020. Operation time, radiation exposure, bone cement injection volume, and the incidence of bone cement leakage were recorded for presentation, and the cement leakage and bone cement distribution were measured by X-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes.
There was no significant difference in the operation time, radiation exposure time, and incidence of bone cement leakage between the two groups. A significant difference was observed in the volume of bone cement injection between the two groups. All patients in both groups had significantly less pain after the procedures, compared with their preoperative period pain. There were no significant differences in Visual Analogue Scale, the relative height of the vertebral body, Cobb angle, and Quality of Life Questionnaire of the European Foundation for Osteoporosis between the two groups at 1 week after PKP, significant difference was observed only 12 months after operation.
Application of directional bone cement delivery device is safe and feasible, compared with the application of traditional bone cement delivery device, without prolonging the operative time, radiation exposure time, and the incidence of bone cement leakage. It has the advantages of good short- and medium-term effect, excellent bone cement distribution, and low incidence of kyphosis recurrence.
经皮椎体后凸成形术（PKP）已被证明在治疗骨质疏松性椎体压缩性骨折（OVCF）方面是有效的。然而，双侧穿刺技术需要更多的时间来接受更多的 X 射线辐射；一些脊柱外科医生应用单侧穿刺 PKP，但骨水泥不能在椎体中对称分布，因此我们应用定向骨水泥输送装置，通过单侧椎弓根穿刺进行 PKP。本研究旨在比较单侧椎弓根入路应用传统骨水泥输送装置和定向骨水泥输送装置行 PKP 的临床和影像学结果，并确定定向输送装置在老年胸腰椎压缩性骨折治疗中的价值。
我们回顾性分析了 2018 年 1 月至 2020 年 1 月期间采用单侧椎弓根穿刺 PKP 治疗的单节段 OVCF 患者。记录手术时间、放射暴露时间、骨水泥注射量和骨水泥渗漏发生率，并通过 X 线和 CT 扫描测量骨水泥渗漏和骨水泥分布。术后对患者进行随访，主要评估临床和影像学结果。
两组患者在手术时间、放射暴露时间和骨水泥渗漏发生率方面无显著差异。两组患者骨水泥注射量有显著差异。两组患者术后疼痛均明显减轻，与术前相比差异有统计学意义。两组患者在 PKP 后 1 周的视觉模拟量表、椎体相对高度、Cobb 角和欧洲骨质疏松症基金会生活质量问卷均无显著差异，仅在术后 12 个月时观察到差异。
与传统骨水泥输送装置相比，应用定向骨水泥输送装置安全可行，不会延长手术时间、放射暴露时间和骨水泥渗漏发生率。具有良好的短期和中期效果、良好的骨水泥分布和较低的后凸畸形复发率的优点。
