Modified unilateral transpedicular percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures.

Abstract

To comparatively assess the clinical outcome of modified unilateral percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures. The clinical outcome and incidence of cement extrusion in a consecutive group of 70 patients at our institution between December 2005 and December 2008 was retrospectively reviewed. Thirty-five patients were randomly distributed to modified percutaneous vertebroplasty (Group A) and 35 to traditional percutaneous vertebroplasty (Group B). A visual analog scale (VAS) was used on the first post-operative day and 1 year later to assess the severity of pain before and after vertebroplasty. The incidence of cement extrusion on CT scan was also compared between the two groups. The treatment was successful in all seventy patients. The incidence of cement extrusion was 14.29% (5/35 patients) in group A, and 37.12% (13/35 patients) in group B, this difference being statistically significant (P < 0.05). No patients had serious complications. Complete pain relief was achieved in 50 patients, and significant relief in the other 20 (20/70 patients). There was no statistically significant difference between Groups A and B. Modified percutaneous vertebroplasty enhances the accuracy of cement injection into the center of the vertebral body, increasing the safety of the procedure with no increase in cost. It is a safer and more easily performed technique for treating patients with osteoporotic vertebral compression fractures than traditional percutaneous vertebroplasty. © 2011 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.