Unilateral or bilateral percutaneous vertebroplasty for acute osteoporotic vertebral fracture: a prospective study

J Spinal Disord Tech. 2015 Mar;28(2):E85-8. doi: 10.1097/BSD.0000000000000147.

Abstract

Background: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, the matter of which surgical approach should be selected remains controversial. This research aims to compare the clinical results of unilateral and bilateral PVP for AOVF.

Methods: From January 2008 to December 2011, 68 patients with AOVF were randomly assigned to the unilateral puncture group (n=36) or the bilateral group (n=32). These patients underwent percutaneous injection of polymethyl methacrylate into posterior pedicle by the unilateral or bilateral puncture approach. Visual analogue scale (VAS) and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) were recorded on presentation, at 1 week, 3, 6, and 12 months after operation. The cement leakage was measured by x-ray and computed tomography scan.

Results: Follow-up data showed there were no significant differences in VAS and QUALEFFO between 2 groups at 1 week after PVP and only significant difference was observed between 2 groups at 3, 6, and 12 months after operation. The cement leakage was 52.7% in the unilateral puncture group and 28.1% in the bilateral group.

Conclusions: Compared with unilateral puncture, use of bilateral approach during PVP may result in more superior long-term outcomes and less cement leakage for patients with AOVF.

MeSH terms

  • Acute Disease
  • Aged
  • Bone Cements / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Spinal
  • Male
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods*
  • Osteoporotic Fractures / psychology
  • Osteoporotic Fractures / surgery*
  • Pain Measurement
  • Polymethyl Methacrylate / administration & dosage
  • Polymethyl Methacrylate / adverse effects
  • Prospective Studies
  • Quality of Life
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery
  • Spinal Fractures / psychology
  • Spinal Fractures / surgery*
  • Treatment Outcome
  • Vertebroplasty / adverse effects
  • Vertebroplasty / methods*

Substances

  • Bone Cements
  • Polymethyl Methacrylate