Zheng Huo-Liang, Liu Chang-Hai, Jiang Lei-Sheng, Zheng Xin-Feng, Jiang Sheng-Dan
Department of Clinic of Spine Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
Orthop Surg. 2025 May;17(5):1322-1331. doi: 10.1111/os.70004. Epub 2025 Apr 2.
Evaluate the efficacy of a novel unilateral dual-plane puncture technique in improving bone cement distribution and reducing vertebral re-collapse following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs). By introducing the novel unilateral dual-plane puncture technique, this study aims to improve cement distribution, reduce the incidence of re-collapse, and enhance long-term clinical outcomes for patients suffering from OVCFs.
This is a randomized trial conducted from April 2021 to December 2022, enrolling 145 patients diagnosed with OVCFs. Patients were allocated into either traditional or unilateral dual-plane puncture groups. Bone cement distribution, vertebral height, and segmental kyphotic angle were measured through postoperative x-ray, while clinical outcomes were evaluated using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). Statistical analysis was performed using the Mann-Whitney U test and independent samples t test for continuous variables, and chi-square or Fisher's exact test for categorical variables.
The unilateral dual-plane puncture technique notably augmented bone cement contact with both superior and inferior endplates compared to conventional methods, achieving rates of 64.86% versus 40.85% (p < 0.001). This contributed to a significant reduction in the incidence of vertebral re-collapse within the first year post-operation: 18.92% in the unilateral dual-plane group as opposed to 42.25% in the traditional group (p < 0.001). Furthermore, the unilateral dual-plane group exhibited markedly superior long-term efficacy, evidenced by mean VAS and ODI scores of 1.26 and 28.58, respectively, in comparison to 2.03 and 32.45 in the traditional group.
The unilateral dual-plane puncture technique advances bone cement distribution within the vertebra, thereby reducing the risk of vertebral re-collapse following PVP surgery and improving long-term clinical outcomes for patients with OVCFs.
评估一种新型单侧双平面穿刺技术在改善经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩骨折（OVCFs）后骨水泥分布及减少椎体再塌陷方面的疗效。通过引入这种新型单侧双平面穿刺技术，本研究旨在改善骨水泥分布，降低再塌陷发生率，并提高OVCFs患者的长期临床疗效。
这是一项于2021年4月至2022年12月进行的随机试验，纳入145例被诊断为OVCFs的患者。患者被分为传统组或单侧双平面穿刺组。通过术后X线测量骨水泥分布、椎体高度和节段性后凸角，同时使用视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评估临床疗效。对连续变量采用Mann-Whitney U检验和独立样本t检验进行统计分析，对分类变量采用卡方检验或Fisher精确检验。
与传统方法相比，单侧双平面穿刺技术显著增加了骨水泥与上下终板的接触，接触率分别为64.86%和40.85%（p<0.001）。这有助于显著降低术后第一年内椎体再塌陷的发生率：单侧双平面组为18.92%，而传统组为42.25%（p<0.001）。此外，单侧双平面组表现出明显更好的长期疗效，平均VAS和ODI评分分别为1.26和28.58，而传统组为2.03和32.45。
单侧双平面穿刺技术改善了椎体内骨水泥分布，从而降低了PVP手术后椎体再塌陷的风险，并改善了OVCFs患者的长期临床疗效。
