[Unilateral multiple channels approach in percutaneous vertebroplasty for osteoporotic vertebral fractures].

OBJECTIVE

To explore the therapeutic efficacy of unilateral multiple channels approach in percutaneous vertebroplasty (PVP) for osteoporotic vertebral fractures.

METHODS

A retrospective review (from March 2003 to October 2012) was conducted on 685 consecutive patients, a total of 885 vertebrae were involved. Eighty-two cases (99 vertebrae) with bone cement leakage when less than 0.3 ml bone cement was injected to fill the fracture were given PVP procedure by unilateral multiple channels approach. 38 cases were male (45 vertebrae) and 44 cases were female (54 vertebrae). The average age was 75.4 years old (from 69 to 92). The operation time, amount of injected bone cement and complications were recorded. Rate of excellent and good outcomes was studied by measuring the cement distribution on the X-ray film. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function respectively at preoperation and 1 hour, 1 month, 3 months and 6 months after operation.

RESULTS

All these ninety-nine vertebrae were treated in 82 cases with PVP of unilateral multiple channels approach. The average operation time was 33 minutes. The rate of excellent and good outcomes of cement distribution was 98.8%. The VAS score was (8.40 +/- 0.73) before surgery,and (2.50 +/- 0.43), (2.00 +/- 0.33), (1.80 +/- 0.28), (2.10 +/- 0.17) at 1 hour, 1 month,3 months and 6 months respectively after operation. ODI was (40.94 +/- 2.72) before surgery, (9.64 +/- 2.60) at 1 month after surgery, (8.52 +/- 2.30) at 3 months after surgery and (7.77 +/- 2.15) at the final follow-up. The differences of the VAS and ODI between pre-operation and post-operation had statistical significance (P<0.01). No spine or nerve injuries occurred intraoperatively.

CONCLUSION

The unilateral multiple channels approach in percutaneous vertebroplasty can obviously relieve the pain and effectively improve the functional activity, provide a satisfied cement distribution in vertebral body with cement leakage after a small amount infusion.