Ege Tolga, Yüzügüldü Uğur, Başak Ali Murat, Aydın Mustafa, Erşen Ömer, Emre Tuluhan Yunus
Department of Orthopedics and Traumatology, Gülhane Training and Research Hospital, 06010 Ankara, Turkey.
Department of Orthopedics and Traumatology, Atatürk Training and Research Hospital, 10100 Balikesir, Turkey.
Medicina (Kaunas). 2025 Apr 3;61(4):663. doi: 10.3390/medicina61040663.
Balloon kyphoplasty is one of the most commonly performed minimally invasive surgical procedures for the treatment of osteoporotic vertebral fractures, with the bipedicular technique being the conventional approach. However, the use of both pedicles may present certain disadvantages, including higher costs, longer operative times, increased radiation exposure, and a greater risk of bone cement leakage. This study aims to report the 3-year follow-up outcomes of double-pedicle and single-pedicle kyphoplasty performed at our institution. Between June 2016 and May 2019, a total of 136 patients who presented to our clinic with osteoporotic vertebral fractures and underwent balloon kyphoplasty were included in this retrospective study. Pain relief and quality of life indices were assessed preoperatively and postoperatively. During follow-up examinations, radiographs, VAS (Visual Analog Scale) scores, and ODI (Oswestry Disability Index) scores were evaluated. Radiation exposure was assessed using fluoroscopy time and dose area product (DAP) values. Additionally, total injected cement volume, operative time, and procedural complications were retrieved from patient records. The procedure was successful in all patients. The mean bone cement volume used was 3.4 ± 1.4 mL in the unipedicular group and 5.3 ± 2.1 mL in the bipedicular group. Fluoroscopy time and DAP values were significantly higher in the bipedicular technique compared to the unipedicular technique. At the final follow-up, the average kyphosis correction and mean vertebral height correction ratio were greater in the bipedicular group. The mean reduction in VAS and ODI scores was superior in the bipedicular group at the 1-, 2-, and 6-month follow-ups. However, at the 1-, 2-, and 3-year follow-ups, there was no significant difference in VAS and ODI scores between the two groups. The unipedicular balloon kyphoplasty technique offers several advantages, including shorter operative time, lower cement leakage risk, reduced radiation exposure, and comparable pain score reductions at 1- to 3-year follow-ups. However, the bipedicular technique provides superior short-term pain relief and demonstrates better sagittal alignment correction in long-term follow-ups compared to the unipedicular approach.
球囊后凸成形术是治疗骨质疏松性椎体骨折最常用的微创手术之一，双椎弓根技术是传统方法。然而，使用双侧椎弓根可能存在某些缺点，包括成本更高、手术时间更长、辐射暴露增加以及骨水泥渗漏风险更大。本研究旨在报告在我们机构进行的双椎弓根和单椎弓根后凸成形术的3年随访结果。2016年6月至2019年5月，共有136例因骨质疏松性椎体骨折前来我院就诊并接受球囊后凸成形术的患者纳入本回顾性研究。术前和术后评估疼痛缓解情况和生活质量指标。在随访检查期间，评估X线片、视觉模拟评分（VAS）和奥斯维斯特里功能障碍指数（ODI）评分。使用透视时间和剂量面积乘积（DAP）值评估辐射暴露。此外，从患者记录中获取注入的骨水泥总体积、手术时间和手术并发症。所有患者手术均成功。单椎弓根组使用的平均骨水泥体积为3.4±1.4 mL，双椎弓根组为5.3±2.1 mL。与单椎弓根技术相比，双椎弓根技术的透视时间和DAP值明显更高。在最后一次随访时，双椎弓根组的平均后凸矫正和平均椎体高度矫正率更高。在1个月、2个月和6个月随访时，双椎弓根组的VAS和ODI评分平均降低幅度更大。然而，在1年、2年和3年随访时，两组之间的VAS和ODI评分没有显著差异。单椎弓根球囊后凸成形术技术具有几个优点，包括手术时间短、骨水泥渗漏风险低、辐射暴露减少以及在1至3年随访时疼痛评分降低程度相当。然而，与单椎弓根方法相比，双椎弓根技术在短期疼痛缓解方面更优，并且在长期随访中显示出更好的矢状位对线矫正效果。
