Efficacy and complications of different viscosities of high-dose
bone cement applied in percutaneous vertebroplasty

doi:10.3969/j.issn.2095-4344.2285

Abstract

Abstract:

BACKGROUND: Percutaneous vertebroplasty has been extensively applied in the treatment of senile osteoporotic vertebral compression fracture with pain. However, the appropriate dose of bone cement remains controversial.

OBJECTIVE: To compare the efficacy and complications of different viscosities of high-dose bone cement applied in the treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty.

METHODS: One hundred and sixty-nine patients with single-segment osteoporotic fractures at thoracolumbar level (T₁₂-L₂) admitted at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from February 2014 to December 2018 were included. All patients were treated by percutaneous vertebroplasty with high-dose (> 4 mL) bone cement at low viscosity (n=85, control group) and high viscosity (n=84, observation group). The Visual Analogue Scale score, anterior vertebral height, Cobb angle and bone cement leakage were recorded before and 2 days after surgery. The study was approved by the Medical Ethics Committee of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, China (approval No. SH9H-2019-T90-1).

RESULTS AND CONCLUSION: (1) The Visual Analogue Scale score at postoperative 2 days in both groups were significantly lower than that at baseline (P < 0.05), and there was no significant difference between the observation and control groups (P > 0.05). (2) The anterior vertebral height at postoperative 2 days in both groups was significantly higher than that at baseline (P < 0.05), and there was no significant difference between two groups (P > 0.05). (3) Compared with the baseline level, the Cobb angle at postoperative 2 days in both groups was significantly decreased (P < 0.05), and there was no significant difference between two groups (P > 0.05). (4) The incidence of bone cement leakage in the observation group (36/84, 42.9%) was significantly lower than that in the control group (57/85, 67.1%) (P < 0.05). The incidence of leakage in paravertebral vessels and spinal canal in the observation group was significantly lower than that in the control group (P < 0.05). (5) Peri-implant infection, allergic reaction, immune and rejection reactions occurred in neither groups. (6) These results indicate that treatment of senile osteoporotic vertebral compression fractures with high dose of low- and high-viscosity bone cement can result in good clinical outcomes. However, the incidence of leakage is higher in the low-viscosity bone cement, and high-viscosity bone cement can significantly reduce the risk of leakage, especially the leakage of paravertebral blood vessels and spinal canal.

Key words: percutaneous vertebroplasty, high-viscosity bone cement, low-viscosity bone cement, osteoporosis, vertebral compression fracture, spinal implant, bone cement leakage, complication, vertebral height

CLC Number:

Wang Mengran, Fu Zhiyi, Wang Huidong, Wu Yujie.

Efficacy and complications of different viscosities of high-dose bone cement applied in percutaneous vertebroplasty [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(16): 2500-2505.

Figures/Tables 6

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