关键词: 骨质疏松压缩骨折, Kambin 三角, 椎体成形术, 临床疗效, 并发症, 骨科植入物, 脊柱植入物

Abstract: BACKGROUND: Currently, the main purpose of surgical treatment for lumbar compression fractures is to improve symptoms, reduce pain, improve quality of life, minimize surgical risks, and reduce surgical exposure time.
OBJECTIVE: To explore the safety and clinical efficacy of percutaneous vertebroplasty via Kambin’s triangle in the treatment of senile spinal deformity accompanied by osteoporotic vertebral compression fractures. 
METHODS: A retrospective analysis was conducted on 31 patients with spinal deformity and osteoporotic vertebral compression fractures who were admitted to Tianjin Union Medical Center from January 2019 to December 2022. There were 21 males and 10 females, aged between 60 and 84 (70.0±10.3) years old. The duration of illness ranged from 1 to 6 (3.5±1.7) weeks. A total of 35 vertebral segments were affected. The distribution of vertebral compression fractures included: 10 cases of L1 fracture, 12 cases of L2 fracture, 2 cases of L1+L2 fracture, 5 cases of L3 fracture, and 2 cases of L1+L3 fracture. Based on the surgical approach, patients were divided into two groups: group A (via Kambin’s triangle approach) with 15 cases, and group B (via traditional pedicle puncture) with 16 cases. Unilateral approach vertebroplasty was performed on both groups. The surgical duration, number of radiation exposures, presence of bone cement leakage, occurrence of complications such as nerve and vascular injuries were recorded in both groups. Postoperative CT scans were used to observe the dispersion and hardening of bone cement. 
RESULTS AND CONCLUSION: (1) In the group A, the surgical duration was 21-30 minutes per vertebra, with an average of (25.0±5.7) minutes. In the group B, the surgical duration was 25-43 minutes per vertebra, with an average of (33.0±7.2) minutes. The surgical duration for puncturing a single vertebra was significantly longer in the group B compared to the group A, with a statistically significant difference (P < 0.05). (2) The average number of radiation exposures per vertebra during surgery was (6.2±1.6) in the group A and (9.3±1.8) in the group B, with a statistically significant difference between the two groups (P < 0.05). (3) In the group A, no bone cement leakage was found. In group B, 2 cases had bone cement leakage, and 1 case had bone cement entering the spinal canal, but no obvious neurological symptoms were observed. The leakage rate was 13%. Both groups had 1 case of subcutaneous hematoma. (4) Postoperative CT scans for observing the distribution of bone cement in the vertebral body showed that the rates of uniform dispersion of bone cement within the vertebrae were 71% and 33% in the groups A and B, respectively, with a statistically significant difference between the two groups (P < 0.05). (5) It is suggested that percutaneous vertebroplasty via Kambin’s triangle approach offers advantages such as shorter surgical duration, better dispersion and filling of bone cement within the vertebrae, lower risk of complications, reduced radiation exposure, and satisfactory results with unilateral puncture.

Key words: osteoporotic compression fracture, Kambin’s triangle, vertebroplasty, clinical efficacy, complication, orthopedic implant, spinal implant