Percutaneous mesh-container-plasty versus percutaneous kyphoplasty in the treatment of osteoporotic compression fractures with up-endplate injury: a retrospective study

Background: Percutaneous mesh-container-plasty（PMCP），a modified traditional percutaneous kyphoplasty（PKP）technique，is increasingly being used to treat osteoporotic vertebral compression fractures（OVCF） with up-endplate injury. This retrospective study aimed to compare the clinical and radiological results of PKP and PMCP for the treatment of this disease. Methods: We reviewed the records of patients with osteoporosis compression fracture and upper endplate injury in our hospital from January 2019 to December 2021.One hundred and ninety-two patients who sustained osteoporosis compression fracture and upper endplate injury without neurological deficits were included in this study according to the inclusion and exclusion criteria.103 patients underwent PKP surgery，and 89 patients underwent PMCP surgery. Results: The VAS and ODI scores improved in the PKP and the PMCP. The anterior vertebral body height ratio (AVBHr) and Cobb's angle showed recovery, but there was no significant statistical difference between BMCP and PKP groups. The amount of bone cement injection and the duration of patient hospitalization were similar between the two groups. But the incidence of cement leakage and adjacent vertebral fracture was lower in the PMCP group (9/89 and 3/89) than in the PKP group (24/103 and 12/103) (p < 0.05). The operation time and fluoroscopy time in the PMCP group (35.23 ± 8.54 minutes and 13.26 ± 3.34 minutes) were significantly lower than that in the PKP group（44.64 ± 9.88 minutes and 18.43 ± 4.87 minutes）(p < 0.05). Conclusions：The BMCP group demonstrated favorable treatment outcomes in managing osteoporotic compression fractures with up-endplate injury. Additionally, it showed shorter operation and fluoroscopy times. Moreover, the postoperative probabilities of adjacent vertebral fractures and bone cement leakage were lower.