Abstract: BACKGROUND: Studies have shown that patients with osteoporotic vertebral compression fractures exhibit significant individual differences in prognostic outcomes. The underlying mechanisms are closely associated with the choice of surgical technique, the distribution characteristics of bone cement within the vertebral body, and the degree of height restoration of the injured vertebra.
OBJECTIVE: To explore the difference in bone cement dispersion height between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures.
METHODS: A total of 112 patients with single-segment osteoporotic vertebral compression fractures admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from May 2019 to February 2025 were included. They were divided into a percutaneous vertebroplasty group (n=57) and a percutaneous kyphoplasty group (n=55) based on the surgical procedure. The visual analog scale score, Oswestry Disability Index, local kyphotic angle of the injured vertebra, and complication rates were compared between the two groups at 6 months postoperatively. The bone cement dispersion heights in the anterior and middle columns of the vertebral body, as well as the maximum dispersion height, were also compared between the two groups. Pearson correlation analysis was used to evaluate the relationship between bone cement dispersion height and the Oswestry Disability Index at 6 months after surgery.
RESULTS AND CONCLUSION: (1) At 6 months postoperatively, the visual analog scale score, Oswestry Disability Index, and local kyphotic angle were significantly lower than preoperative values in both groups (P < 0.05). At 6 months after surgery, the percutaneous kyphoplasty group showed significantly lower visual analog scale scores, Oswestry Disability Index, and local kyphotic angle compared with the percutaneous vertebroplasty group (P < 0.05). There was no significant difference in the rates of bone cement leakage or adjacent vertebral fracture between the two groups (P > 0.05). (2) The bone cement dispersion heights in the anterior and middle columns, as well as the maximum dispersion height, were significantly greater in the percutaneous kyphoplasty group than in the percutaneous vertebroplasty group (P < 0.05). (3) Pearson correlation analysis revealed a significant negative correlation between the anterior column bone cement dispersion height (and maximum dispersion height) and the Oswestry Disability Index at 6 months postoperatively (r=-0.730, P < 0.001; r=-0.700, P < 0.001; r=-0.581, P < 0.001; r=-0.468, P < 0.001). No significant correlation was found between the middle column bone cement dispersion height and the Oswestry Disability Index at 6 months postoperatively (r=-0.089, P < 0.520; r=-0.024, P < 0.859). (4) The results indicate that the three-dimensional dispersion height of bone cement within the vertebral body can serve as a potential imaging predictor for evaluating the efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty. 

Key words: osteoporotic fractures, percutaneous vertebroplasty, percutaneous kyphoplasty, three-dimensional dispersion of bone cement, quantitative