Effect of "patch technique" in PVP treatment on OVCF with anterior vertebral wall rupture

ObjectiveTo explore the application and therapeutic effect of "patch technique" in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF) with rupture of the anterior vertebral body.

MethodsA total of 72 OVCF patients with rupture of the anterior vertebral body who underwent PVP were selected.All patients were randomly divided into three groups, 24 cases in each group.Group A: bone cement injection during wet-sand phase, group B: bone cement injection during wire-drawing phase, group C: the "patch technique" was used to seal the fracture of the anterior vertebral body with bone cement in the early dough stage of paste, and then bone cement was injected in wet-sand phase.Both sides were penetrated during the operation, with basically same injection speed and 4-5 mL of bone cement volume for each side.Postoperative X-ray films were taken to observe the diffusion and leakage of bone cement.The pain relief of patients in the three groups was evaluated using the Oswestry disability index (ODI) before and 2 days post operation.

ResultsIn group A, the cement in diseased vertebral body was relatively evenly distributed, while type-C leakage occurred in 13 cases (54.17%).In group B, the cement distribution in postoperative diseased vertebral body was relatively scattered, with 5 cases having type-C leakage(20.83%).In the group C, the cement in diseased vertebral body was relatively evenly distributed, there was only 1 case of type-C leakage(4.17%).There was significant difference in leakage rate among the three groups (P < 0.01).There was no significant difference in preoperative ODI scores among the three groups(P>0.05).On the second day after operation, the ODI scores of the three groups were significantly lower than those before operation (P < 0.01), and the ODI scores of group A and group C were significantly lower than those of group B, but there was no significant difference between group A and group C(P>0.05).

ConclusionsThe "patch technique" in PVP is beneficial for the even distribution of bone cement in the diseased vertebral body, reducing the occurrence of re-fracture, and alleviating postoperative pain.In addition, due to the lower leakage rate, this technique shows higher safety.