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Published on: August 9, 2024
Unilateral Pedicular Puncture with Lateral Injection for Osteoporotic Vertebral Compression Fractures in the Upper
Feng Huang1, Yi Hang He1, Lu Lin1
1Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background:
Percutaneous vertebroplasty (PVP) for upper and middle thoracic osteoporotic vertebral compression fractures (OVCFs) is challenged by technical difficulties and safety concerns, which drive the need for innovative techniques to optimize its efficacy. The purpose of this study was to delineate the technical characteristics of a novel methodology and to conduct a comparative analysis of its efficacy against bilateral transpedicular puncture PVP.
Methods:
A retrospective study was conducted on consecutive patients undergoing PVP for upper/middle thoracic OVCFs at the Second Affiliated Hospital of Chongqing Medical University (Chongqing, China) between January 2019 and December 2024. Patients were allocated to either the unilateral transpedicular puncture lateral injection (UTPLI) or the conventional bilateral transpedicular puncture (BTP) group based on the surgical timeline, with earlier cases undergoing BTP and later ones UTPLI. Baseline characteristics, operative time, estimated blood loss, cement volume, visual analogue scale (VAS), Oswestry disability index (ODI), vertebral and segmental kyphosis angles, anterior/middle/posterior vertebral heights, and postoperative cement distribution indices were recorded and compared between the two groups. Data were analyzed with SPSS software (version 26.0) using Chi square, t tests, and non-parametric tests.
Results:
A total of 57 patients were enrolled (UTPLI group=21, BTP group=36). The UTPLI group had a shorter operation time (18.00±9.00 min vs. 25.00±9.00 min, P=0.002) and less estimated blood loss (3.93±1.22 mL vs. 5.13±1.37 mL, P=0.002). No significant intergroup differences were found in VAS, ODI, kyphosis angles (vertebral, segmental, thoracic), vertebral heights (anterior, middle, posterior), baseline data, bone cement leakage, cement dispersion index, or spatial distribution scores, either preoperatively or postoperatively (P>0.05).
Conclusion:
The UTPLI technique is a viable alternative to BTP PVP for upper and middle thoracic OVCFs. It reduced operative time and blood loss while achieving comparable outcomes.
