Effect of low-temperature modulation of bone cement viscosity on the efficacy of cement dispersion and clinical outcomes after percutaneous kyphoplasty: a retrospective cohort study.

BACKGROUND

The distribution of bone cement within the vertebral body is an important factor affecting the clinical outcome of percutaneous kyphoplasty (PKP). However, the modulation of the effect of bone cement dispersion has not been explored.

METHODS

We analyzed 199 patients with OVCFs who underwent single-segment PKP surgery in our hospital from June 2020 to October 2022. According to the different temperature preconditioning of bone cement, the patients were divided into three groups: the Low Temperature Group (n = 68), the Normal Saline Group (n = 65), and the Room Temperature Group (n = 66). The primary outcomes were the bone cement dispersion score and the postoperative vertebral refracture rate. The secondary outcomes included the Cobb's angle correction rate, the vertebral anterior margin height recovery rate, and the postoperative efficacy score.

RESULTS

The bone cement hardening time in the NS and RT groups was significantly lower than that in the LT group ( P  < 0.001). The LT group obtained the optimal bone cement dispersion scores. The Cobb's angle correction rate and vertebral anterior margin height restoration rate of the LT group were lower than those of the NS and RT groups ( P  < 0.001). Its overall postoperative refracture rate was 11.76%, which was lower than 21.54% in the NS group and 31.82% in the RT group ( P = 0.019). At the final follow-up, the LT group had a better VAS score ( P < 0.001), but there was no significant difference in the ODI score ( P = 0.178).

CONCLUSION

By modulating the bone cement viscosity through low temperature, it can safely and effectively improve the distribution of bone cement in the fractured vertebrae, reduce the occurrence rate of postoperative refractures and the risk of long-term residual back pain for patients, and improve the clinical efficacy of patients.