Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures

Abstract This study aimed to investigate the therapeutic effects and radiographic results of percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCFs) with or without intravertebral clefts (IVCs). Clinical data from 288 patients with OVCFs who underwent PKP...

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Main Authors: Yuzhi Ning, Yuxuan Sun, Shuang Xu, Heng Wu, Daxiong Feng, Qing Wang, Song Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11749-6
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author Yuzhi Ning
Yuxuan Sun
Shuang Xu
Heng Wu
Daxiong Feng
Qing Wang
Song Wang
author_facet Yuzhi Ning
Yuxuan Sun
Shuang Xu
Heng Wu
Daxiong Feng
Qing Wang
Song Wang
author_sort Yuzhi Ning
collection DOAJ
description Abstract This study aimed to investigate the therapeutic effects and radiographic results of percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCFs) with or without intravertebral clefts (IVCs). Clinical data from 288 patients with OVCFs who underwent PKP surgery were retrospectively analyzed and stratified into the liquid-IVC group, gas-IVC group, and non-IVC group through magnetic resonance imaging. The baseline characteristics revealed that the liquid-IVC group included older patients and a greater proportion of male participants (P < 0.05). All patients reported pain relief, vertebral height (VH) improvement, and kyphotic angle correction immediately after PKP surgery (P < 0.05). The bone cement distribution score was significantly lower (P < 0.05) in the liquid-IVC group than in the other two groups, but the VH improvement rate (VHIR), VH change rate (VHCR) and recollapse rate were significantly greater (P < 0.05). Moreover, the non-IVC group demonstrated a significantly lower incidence of postoperative bone cement leakage than the other two groups did (P < 0.05). However, the VH and Cobb angle significantly decreased in all groups during the follow-up period (P < 0.05). Further analysis revealed a significant correlation between bone cement distribution and IVC (by evaluating the injury zone score) in the liquid-IVC group (R2 = 0.371, P < 0.05), whereas no significant difference was found in the other two groups (R2 = −0.123, P = 0.218). In conclusion, PKP surgery is effective in treating OVCFs with or without IVCs, but liquid-filled IVCs exhibit a worse therapeutic effect on radiographic parameters than gas-filled IVCs and non-IVCs during follow-up. Patients with liquid-filled IVCs also have limited and IVC-related bone cement distribution.
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spelling doaj-art-e5a6a6a8f7ab41baaa6397bee42cb3922025-08-20T04:02:46ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-11749-6Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fracturesYuzhi Ning0Yuxuan Sun1Shuang Xu2Heng Wu3Daxiong Feng4Qing Wang5Song Wang6Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityDepartment of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityDepartment of Orthopedics, The Affiliated Hospital of Southwest Medical University, Southwest Medical UniversityAbstract This study aimed to investigate the therapeutic effects and radiographic results of percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCFs) with or without intravertebral clefts (IVCs). Clinical data from 288 patients with OVCFs who underwent PKP surgery were retrospectively analyzed and stratified into the liquid-IVC group, gas-IVC group, and non-IVC group through magnetic resonance imaging. The baseline characteristics revealed that the liquid-IVC group included older patients and a greater proportion of male participants (P < 0.05). All patients reported pain relief, vertebral height (VH) improvement, and kyphotic angle correction immediately after PKP surgery (P < 0.05). The bone cement distribution score was significantly lower (P < 0.05) in the liquid-IVC group than in the other two groups, but the VH improvement rate (VHIR), VH change rate (VHCR) and recollapse rate were significantly greater (P < 0.05). Moreover, the non-IVC group demonstrated a significantly lower incidence of postoperative bone cement leakage than the other two groups did (P < 0.05). However, the VH and Cobb angle significantly decreased in all groups during the follow-up period (P < 0.05). Further analysis revealed a significant correlation between bone cement distribution and IVC (by evaluating the injury zone score) in the liquid-IVC group (R2 = 0.371, P < 0.05), whereas no significant difference was found in the other two groups (R2 = −0.123, P = 0.218). In conclusion, PKP surgery is effective in treating OVCFs with or without IVCs, but liquid-filled IVCs exhibit a worse therapeutic effect on radiographic parameters than gas-filled IVCs and non-IVCs during follow-up. Patients with liquid-filled IVCs also have limited and IVC-related bone cement distribution.https://doi.org/10.1038/s41598-025-11749-6Osteoporotic vertebral compression fracturesIntravertebral cleftsPercutaneous kyphoplastyBone cement distribution
spellingShingle Yuzhi Ning
Yuxuan Sun
Shuang Xu
Heng Wu
Daxiong Feng
Qing Wang
Song Wang
Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
Scientific Reports
Osteoporotic vertebral compression fractures
Intravertebral clefts
Percutaneous kyphoplasty
Bone cement distribution
title Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
title_full Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
title_fullStr Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
title_full_unstemmed Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
title_short Impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
title_sort impact of intravertebral cleft types on percutaneous kyphoplasty outcomes in osteoporotic vertebral compression fractures
topic Osteoporotic vertebral compression fractures
Intravertebral clefts
Percutaneous kyphoplasty
Bone cement distribution
url https://doi.org/10.1038/s41598-025-11749-6
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