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Percutaneous Curved Vertebroplasty Versus Unipedicular Approach Vertebroplasty for Acute Osteoporotic Vertebral Compression Fractures

医学 经皮椎体成形术 可视模拟标度 Oswestry残疾指数 骨水泥 外科 透视 随机对照试验 背痛 不利影响 压缩(物理) 射线照相术 腰痛 水泥 内科学 椎体 替代医学 考古 病理 历史 材料科学 复合材料
作者
Zhendong Lv,Zehao Chen,Hao Chen,Jieying Wang,Yingchao Han,Xin‐Feng Li,Hongxing Shen,Yuhui Zhang
出处
期刊:Spine [Lippincott Williams & Wilkins]
卷期号:48 (8): 552-558 被引量:6
标识
DOI:10.1097/brs.0000000000004593
摘要

Study Design. Prospective randomized controlled trial. Objective. To clarify whether percutaneous curved vertebroplasty (PCVP) is superior to conventional unipedicular approach vertebroplasty (UVP) in patients with acute osteoporotic vertebral compression fractures (OVCFs). Summary of Background Data. Unilateral curved vertebroplasty devices were designed and applied to provide better control of cement placement, which may be superior to traditional UVP for the treatment of acute OVCFs. Materials and Methods. Patients with single-level OVCFs of <6 weeks duration and visual analog scale (VAS) of back pain 5 or more were randomly allocated to undergo PCVP or UVP and were followed up for 1 year. The primary outcome was overall VAS scores for back pain during 12 months of follow-up. The secondary outcomes were scores on the Oswestry disability index at each postprocedure clinic visit. Radiographic (cement distribution) and surgical data (operation time, fluoroscopy frequency, and cement volume) were assessed. Complications and adverse events were recorded. Results. No statistical difference was found between the PCVP and UVP groups with respect to VAS and Oswestry disability index scores at any follow-up time point. Operative time, fluoroscopy frequency, and cement leakage were similar in both groups, while the PCVP techniques had a larger injection of polymethylmethacrylate (5.5 ± 1.4 vs . 4.2 ± 1.0 mL) and a greater dispersion pattern of cement ( P < 0.001). Post hoc observations found that the analgesic effect was positively correlated with the symmetry of bone cement distribution, but not with the surgical method. Two serious adverse events occurred in the vertebroplasty group: one stress ulcer and one allergic reaction. Conclusions. Although PCVP achieved more symmetrical cement distribution, which seemed to be associated with a greater analgesic effect, PCVP did not result in significantly greater pain relief than a UVP in the 12 months after treatment.
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