Percutaneous vertebroplasty by bone cement perfusion using the unilateral transverse process-pedicle approach for treatment of thoracolumbar osteoporotic vertebral compression fracture

doi:10.3969/j.issn.2095-4344.1327

Abstract

Abstract:

BACKGROUND: During vertebroplasty for treatment of osteoporotic vertebral compression fracture, traditional pedicle puncture route easily punctures the medial wall of the pedicle and causes spinal cord injury.

OBJECTIVE: To investigate the clinical effect of percutaneous vertebroplasty by bone cement perfusion via using the unilateral transverse process-pedicle approach in the treatment of thoracolumbar osteoporotic vertebral compression fracture.

METHODS: Thirty patients (42 vertebral bodies) with osteoporotic vertebral compression fracture who received treatment during November 2016 to March 2017 in the Fifth Affiliated Hospital of Zhengzhou University, China were included in this study. These patients consisted of 9 males and 21 females, aged 58-82 years. All of them underwent percutaneous vertebroplasty by bone cement perfusion via unilateral transverse process-pedicle approach. Bone cement leakage was recorded. Before treatment, 1 week after treatment and at the last follow-up, imaging was used to observe the recovery of vertebral height and changes of Cobb angle, to measure Visual Analogue Score, which was used to evaluate the pain, and Oswestry Disability Index score, which was used to evaluate the improvement of daily activity function. This study was approved by the Ethics Committee of The Fifth Affiliated Hospital of Zhengzhou University.

RESULTS AND CONCLUSION: All 30 patients successfully completed the operation and were followed up for 6-9 months. Among the 42 vertebral bodies, bone cement leaked to the intervertebral space in 4 vertebral bodies and it leaked to the anterior edge of the vertebral body in 2 vertebral bodies. There was no leakage in the spinal canal, and the total leakage rate was 14%. No adverse clinical symptoms were observed. In 30 patients, Visual Analogue Scores and Oswestry Disability Index scores at 1 week after treatment and at the last follow-up were significantly lower than those before treatment (P < 0.05). In 30 patients, at 1 week after treatment and the last follow-up, the vertebral body height of the patients was significantly higher (P < 0.05), as well as the Cobb angle was significantly lower (P < 0.05), compared with before treatment (P < 0.05). The results suggest that percutaneous vertebroplasty by bone cement perfusion via unilateral transverse process-pedicle approach is a safe and effective method for the treatment of thoracolumbar osteoporotic vertebral compression fracture.

Key words: bone cement leakage, osteoporotic vertebral compression fracture, percutaneous vertebroplasty, transverse process-pedicle approach, thoracolumbar vertebrae, transverse process, pedicle, injured vertebral body height

CLC Number:

R459.9

He Jiangtao, Wang Sanmu, Li Zhongyi. Percutaneous vertebroplasty by bone cement perfusion using the unilateral transverse process-pedicle approach for treatment of thoracolumbar osteoporotic vertebral compression fracture[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(22): 3604-3608.

Figures/Tables 4

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