Comparison of the curative effect of vertebroplasty with spiral and traditional pushrod injector in the treatment of osteoporotic vertebral fractures

Abstract

Abstract Background Cement diffusion and cement leakage are key and contradictory problems in the vertebroplasty, so vertebroplasty instruments constantly develop to explore the optimal treatment. The purpose of this study was to evaluate and compare the clinical efficacy of percutaneous vertebroplasty (PVP) with spiral bone cement injector and traditional push-rod injector in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods A retrospective study was conducted on 86 patients with OVCF who respectively received PVP surgeries with spiral injector (Observation group) and traditional pushrod injector (Control group) from February 2017 to February 2019. The preoperative baseline data, postoperative clinical efficacy, complications and imaging data between the two groups were analyzed. Results Follow-up period was two years. The baseline data of the two groups were comparable (all P > 0.05).The anterior edge height and kyphosis angle of the injured vertebrae were significantly improved in both groups after surgery (all P < 0.05). The VAS and ODI in both groups were significantly lower on 3rd day and 2nd year after surgery than those before surgery, and decreased gradually with time (all P < 0.05). The number of fluoroscopy and operation time in the observation group were significantly lower than those in the control group (all P < 0.05). The kyphosis angle and the recovery rates of kyphosis angle, anterior edge height, and posterior edge height in the observation group were significantly improved compared with the control group (all P < 0.05). The rate of bone cement leakage and the diffusion coefficient of bone cement in the observation group were significantly higher than those of the control group (all P < 0.05). The VAS and ODI in the observation group were significantly lower than those in the control group at 3rd day after surgery (P < 0.05), but there was no statistical difference between the two groups at 2nd year after surgery (P > 0.05). Conclusions PVP surgery both with spiral injector and traditional pushrod injector can achieve satisfactory outcomes, which could effectively relieve pain of lower back, improve motor function, obviously restore vertebral height and correct kyphosis. However, the spiral injector can remarkably reduce the number of fluoroscopy, operation time, and the radiation exposure dose of patients and operators. In addition, spiral injector is better than pushrod injector in restoring vertebral height, correcting kyphosis, alleviating pain immediately and improving function. But its rate of bone cement leakage is significantly higher than that of traditional pushrod injector, which requires the surgeons to pay close attention to.