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| LI Jian,JIANG Yi,ZUO Rujun.Clinical effect of percutaneous kyphoplasty via posterior-superior vertebral margin in the treatment of osteoporotic vertebral compression fractures of the lumbar spine[J].Chinese Journal of Spine and Spinal Cord,2021,(3):222-229. |
| Clinical effect of percutaneous kyphoplasty via posterior-superior vertebral margin in the treatment of osteoporotic vertebral compression fractures of the lumbar spine |
| Received:August 16, 2020 Revised:November 04, 2020 |
| English Keywords:Posterior-anterior vertebral margin Extra-pedicular approach Osteoporotic vertebral compression fracture |
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| English Abstract: |
| 【Abstract】 Objectives: To describe the practice design of percutaneous kyphoplasty(PKP) via posterior-anterior vertebral margin and to evaluate its advantages, disadvantages and clinical efficacy compared with bilateral transpedicular approach PKP. Methods: 67 patients(74 vertebrae) that meet criteria were included into the study to analyze retrospectively. Patients were divided into two groups according to the PKP approaches: observation group(PKP via posterior-anterior vertebral margin) and control group(transpedicular approach PKP). There were 6 males and 23 females in observation group, with an average age of 76.8±8.8 years. There were 9 males and 29 females in control group, with an average age of 77.7±10.2 years. Evaluation indexes included: improvement rate of vertebral height, cement distribution and leakage, puncture angle, operative time, radiation exposure, cement volume, VAS score and ODI score. Results: All the patients successfully went through the operation without puncture-related nerve injury and segmental artery injury. There were no significant differences(P>0.05) in improvement rate of vertebral height[(47.68±23.76)％ vs (48.70±22.10)％], bone cement volume(4.35±1.00ml vs 4.63±0.75ml), unilateral cement distribution rate(6.1％ vs 0), intraspinal cement leakage rate(27.3％ vs 14.6％), intradiscal cement leakage rate(12.1％ vs 9.8％), foraminal cement leakage rate(3.0％ vs 0) and postoperative VAS score(2.10±0.90 vs 1.92±0.67) between the two groups. There were significant differences(P＜0.05) in paravertebral cement leakage rate(30.3％ vs 61.0%), radiation exposure, operative time(39.2±4.7min vs 44.8±5.5min) and puncture angle between the two groups. Conclusions: PKP via posterior-anterior vertebral margin can easily reach the vertebral center and make the cement distribute on bilateral side just by unilateral operation. This approach allows shorter operative time, smaller radiation exposure and lower paravertebral cement leakage rate than bilateral transpedicular approach PKP. And it can achieve similar improvement rate of vertebral height and clinical efficacy as transpedicular approach PKP. |
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