Unilateral and bilateral percutaneous kyphoplasty for thoracolumbar osteoporotic compression fractures

Abstract

Objective: To compare the efficacies of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of thoracolumbar osteoporotic compression fractures. Study Design: Experimental study. Place and Duration of Study: Department of Orthopedics, Hubei 672 Orthopedics Hospital of Integrated Chinese and Western Medicine, China, from November 2014 to January 2017. Methodology: One hundred and seventy-eight patients with single-level thoracolumbar osteoporotic compression fractures included in this study. These patients were randomly assigned to unilateral (n=83) and bilateral (n=95) PKP groups. The operation time, bone cement volume, number of X-ray views, preoperative and postoperative pain visual analogue scale scores (VAS), Oswestry Dysfunction Index (ODI), Cobb angle, and vertebral height in both groups were recorded. Results: Operation time, bone cement volume and intraoperative number of X-ray views were significantly different between unilateral and bilateral PKP groups (29.8 ±2.7 vs. 31.5 ±3.9 minutes; 9.3 ±2.6 vs. 11.2 ±3.7 times; 3.1 ±0.7 vs. 3.5 ±1.2 ml, respectively, p <0.05). VAS scores and ODI in both groups were significantly different before and 24 hours, 3 months and 6 months after surgery. The heights of anterior and middle borders of vertebral body and Cobb angle in the two groups were significantly different before and after surgery (p <0.05). Conclusion: The short-term efficacy was identical between unilateral and bilateral PKP. The unilateral PKP is characterized by short operation time, low hospital cost, less number of X-ray views and less bone cement volume. The unilateral PKP shows a higher risk of re-fracture of adjacent vertebral body compared with the bilateral PKP.