Surgical Results in One-level Vertebroplasty for Osteoporotic Vertebral Fracture in Thoracic or Lumbar Spine: Radiographic Comparison between Low-viscosity Cement and High-viscosity Cement
Background: Percutaneous vertebroplasty (PVP) is a highly effective procedure for managing painful osteoporotic vertebral fractures (VFs). Objectives: The objective of this retrospective study was to compare the surgical outcomes of patients treated with high-viscosity cement (HVC) and low-viscosity...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-10-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/FJMD.FJMD_340 |
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| Summary: | Background:
Percutaneous vertebroplasty (PVP) is a highly effective procedure for managing painful osteoporotic vertebral fractures (VFs).
Objectives:
The objective of this retrospective study was to compare the surgical outcomes of patients treated with high-viscosity cement (HVC) and low-viscosity cement (LVC) at our institution.
Materials and Methods:
A total of 142 patients who underwent one-level PVP between April 2013 and June 2020 were followed up for more than 1 year and were retrospectively included in this study. Among them, 88 patients were categorized into the LVC group, whereas 54 patients were assigned to the HVC group. Radiographic parameters, including vertebral body height (VBH) restoration, vertebral wedge angle (VWA), local kyphotic angle (LKA), incidence of adjacent fractures, cement distribution, and leakage, were evaluated using the follow-up plain radiographs. Univariate and multivariate analyses were conducted to identify the potential risk factors for adjacent fractures.
Results:
The HVC group demonstrated a greater volume of injected cement, leading to significantly improved restoration of VWA and LKA compared to the LVC group (P < 0.05). Conversely, the LVC group exhibited superior immediate restoration of posterior VBH (P < 0.001). The incidences of cement leakage and adjacent fracture were comparable between the two groups (P = 0.227, P = 0.182), respectively. In the HVC group, adjacent fractures were more likely to occur in patients with poorer dual-energy X-ray absorptiometry (DXA) scores, greater injected cement volume, and higher restoration of anterior and middle VBH and VWA (P < 0.05). Conversely, in the LVC group, adjacent fractures tended to occur in patients with better DXA scores.
Conclusions:
Better restoration in LKA and VWA was found in patients augmented by HVC-vertebroplasty. The rates of cement leakage and adjacent fractures were similar between the HVC and LVC groups. Excessive restoration of VWA appeared to elevate the risk of adjacent fractures, emphasizing the need for further biomechanical studies. |
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| ISSN: | 2210-7940 2210-7959 |