Clinical application of controllable bone cement injection during percutaneous vertebroplasty

To compare the clinical efficacy and safety of controllable versus conventional cement injection during percutaneous vertebroplasty (PVP) for vertebral fractures, and to explore the factors associated with poor cement dispersion and leakage.

This single-center retrospective study enrolled 200 patients with vertebral fracture who underwent PVP between Apr 2022 and Mar 2023. Patients were divided into the conventional cement injection group and controllable cement injection group. Visual analogue scale (VAS) scores were evaluated at baseline, postoperative day 1, and 3 months after surgery. In the controllable cement group, leakage rates were compared between the low- and standard-volume cement injection subgroups. Radiological and bone quality-related parameters were further analyzed according to cement dispersion patterns. Multivariate Logistic regression was used to identify independent risk factors for poor cement dispersion and leakage.

VAS scores decreased significantly at postoperative day 1 and month 3 compared with baseline values in both groups (all P<0.05). Compared with the conventional injection group, the controllable bone cement injection group demonstrated shorter operation time, reduced intraoperative blood loss, lower cement injection volume, and shorter hospital stay (all P<0.05). The two groups had similar preoperative VAS scores, whereas the controllable cement injection group presented significantly lower postoperative VAS scores (all P<0.05). In the controllable cement injection group, patients with good cement dispersion achieved greater pain relief than those with poor dispersion (P<0.05). In addition, the low-volume subgroup exhibited a lower cement leakage rate than the standard-volume subgroup (P<0.05). Multivariate Logistic regression identified low bone mineral density, posterior vertebral cortical defects, and large cement injection volume as independent risk factors for poor cement dispersion and leakage.

Controllable bone cement injection during PVP provides superior perioperative outcomes and improved postoperative pain relief compared with conventional cement methods for vertebral fractures.