Lateral versus anterior
open injectors in the percutaneous vertebroplasty treatment of osteoporotic
vertebral compression fractures

doi:10.3969/j.issn.2095-4344.2268

Abstract

Abstract:

BACKGROUND: Studies have shown that lateral open injectors can improve the cement filling pattern in percutaneous vertebroplasty, direct cement flow into the vertebral body, reduce the risk of leakage, and increase the amount of bone cement injected compared with conventional anterior open injectors.

OBJECTIVE: To investigate the clinical efficacy of lateral open injectors in the percutaneous vertebroplasty treatment of osteoporotic vertebral compression fractures and its effect on preventing intraoperative cement leakage.

METHODS: A total of 220 patients with osteoporotic vertebral compression fractures admitted at Harrison International Peace Hospital from January 2014 to December 2018 were enrolled. Of these, 114 patients underwent bilateral pedicle percutaneous vertebroplasty with the lateral open injector, and 106 patients underwent bilateral pedicle percutaneous vertebroplasty with standard anterior open injector. X-ray and CT scans were performed to evaluate bone cement leakage. The Visual Analogue Scale score and vertebral compression rate were evaluated at baseline, postoperative 3 days and 6 months. The study was approved by the Ethics Committee of Harrison International Peace Hospital (approval No. 20131214841X).

RESULTS AND CONCLUSION: (1) All the 220 patients successfully completed the operation without any early complications, the pain was alleviated, and the quality of life was significantly improved. (2) The amount of bone cement injected in the lateral open injector group was higher than that in the anterior open injector group (P < 0.05). (3) The Visual Analogue Scale scores at 3 days and 6 months postoperatively were significantly lower than those at baseline (P < 0.05). There was no significant difference in the Visual Analogue Scale score between two groups (P > 0.05). (4) Twenty-one vertebral bodies in 130 vertebrae in the lateral open injector group showed cement leakage (leakage rate of 16.15%). Bone cement leakage (leakage rate of 30%) occurred in 36 out of 120 vertebral bodies in the anterior open injector group. So the leakage rate of cement in the lateral open injector group was lower than that in the anterior open injector group (P < 0.05). (5) The vertebral compression rate at 3 days and 6 months postoperatively in the two groups was significantly lower than that at baseline (P < 0.05). There was no significant difference in vertebral compression rate between two groups (P > 0.05). (6) These results imply that the use of the lateral open or anterior open injector for bone cement injection for percutaneous vertebroplasty for treatment of osteoporotic vertebral fractures can achieve satisfactory clinical outcomes. However, a lateral open injector can optimize bone cement injection mode, reduce the potential risk of leakage and infiltration into the blood vessels around the vertebral body, and adjust the direction of bone cement injection to achieve a satisfactory bone cement filling effect.

Key words: osteoporosis, vertebral compression fracture, percutaneous vertebroplasty, bone cement, pedicle, efficacy, complications, bone cement leakage

CLC Number:

Pang Jutao, Chen Hong, Liu Bin, Zhang Wei, Sun Jianhua, Zhou Lianjun, Zhang Xinhu. Lateral versus anterior open injectors in the percutaneous vertebroplasty treatment of osteoporotic vertebral compression fractures [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(16): 2461-2466.

Figures/Tables 6

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