Percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compression fractures, unilateral OR bilateral？A large retrospective cohort study

Abstract

Abstract Background:Percutaneous vertebroplasty（PVP）has become one of the main methods for the treatment of osteoporotic thoracolumbar vertebral compression fractures. There is still lack of medium term data on the long-term outcome comparisons between unilateral and bilateral approach. Objective: To compare the efficacy of unilateral and bilateral approach Percutaneous vertebroplasty（PVP）in the treatment of elderly patients with osteoporotic vertebral compression fractures( OVCF). Methods: One hundred and ninety-three patients with symptomatic osteoporotic vertebral compression fractures (OVCF) treated with PVP were retrospectively reviewed in a single institution.Patients were divided into Group A(unilateral approach) and Group B(bilateral approach), based on operative approach. The efficacy was evaluated by perioperative indicators, follow-up results and imaging evaluation.All computations were performed with standard software (SPSS version 22.0 for Windows; IBM). Results：One hundred and sixtyty-nine of 193 eligible patients were included. All the patients received the follow-up visits for 49-70 months.In this case, there were no serious postoperative complications.A significant difference was found between group A and group B in terms of operation time，puncture time，amount of bone cement injected，the number of X-ray fluoroscopy (P < 0.05). the difference in the incidence of cement leakage between the two groups was not statistically significant (P > 0.05)，and the length of hospitalization and hospital costs in group A were lower than those in group B was not statistically significant (P > 0.05).The time of postoperative mobilization was(3.00 ±0.80)weeks in group A and(3.60 ± 0.79)weeks in group B，The difference was statistically significant (P < 0.05).As VAS and ODI scores, the short-term efficacy of the group A was worse than that of the group B, but the difference between the two groups was smaller at the final follow-up(P > 0.05). In terms of imaging evaluation, there were no significant differences between the two groups(P > 0.05). Conclusions: All patients were assessable for safety and efficacy. At the final follow-up, both groups showed significant improvements in the height of the height of the vertebral body and Cobb's angle of kyphosis (P < 0.05).Changes in VAS after PVP, the preoperative pain reduced significantly. Unilateral approach resulted in less blood loss intraoperatively, a shorter operation time, and less number of fluoroscopy(P > 0.05).However, There were no significant differences in the symptomatic scores at the last follow-up.