Clinical effects of the preoperative measurement combined with intraoperative precise puncture percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

ObjectiveTo observe the feasibility and clinical effects of preoperative measurement combined with intraoperative precise puncture percutaneous kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures.

MethodsThe clinical data of 98 single-segment osteoporotic vertebral compression fractures patients treated with PKP were retrospective analyzed.Eighty-five patients were followed up for more than 1 year.According to the puncture method during operation, the patients were divided into the observation group(47 cases) and control group(38 cases).The observation group and control group were treated with preoperative image measurement combined with precise puncture PKP and conventional PKP, respectively.The operative time, number of intraoperative fluoroscopy, recovery of injured vertebral height, postoperative bone cement distribution and leakage were compared between two groups.The pain relief and quality of life improvement in two groups were evaluated using visual analog scale(VAS) and Oswestry disability index(ODI).

ResultsThe operation time and intraoperative fluoroscopy times in observation group were lower than those in control group, and the proportion of bone cement diffusion to the midline in observation group was higher than that in control group(P < 0.05 to P < 0.01).The difference of the amount of intraoperative bone cement injection between two groups was not statistically significant(P>0.05).After surgery, the VAS score and ODI in two groups decreased, the mean height of injured vertebrae and local Cobb angle were significantly recovered compared with those before surgery, and the difference of which was statistically significant(P < 0.01).The differences of the VAS score, ODI, average height of injured vertebrae and local Cobb angle between two groups at different time points were not statistically significant(P>0.05).The results of postoperative CT scan showed that the incidence rates of bone cement leakage in the observation group and control group were 8.5%(4/47) and 21.0%(10/38), respectively, and the difference of which was statistically significant(P < 0.05).

ConclusionsThe preoperative image measurement combined with precise puncture during the PKP can improve the accuracy of vertebral puncture, reduce the operative time and fluoroscopy times.Moreover, it makes the bone cement better diffuse over the midline, and leakage rate of bone cement decrease.