Zhongguo gu shang = China journal of orthopaedics and traumatology · 2026
[Clinical efficacy of low-dose bone cement with different distribution patterns in the treatment of osteoporotic vertebral compression fractures].
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Ma Yubo, Zhou Fei, Ma Yun, Liu Dacheng
Аннотация
OBJECTIVE: To investigate the difference in clinical efficacy between different distribution patterns of low-dose bone cement in percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCFs).
METHODS: A retrospective analysis was conducted on 80 patients with OVCFs treated between March 2022 and March 2024. Based on postoperative imaging evaluation of bone cement distribution, patients were divided into a fused pattern group (fused group, n=40) and a separated pattern group (separated group, n=40). All cases received a single-level injection of 2 to 3 mL of bone cement. The fused group included 14 males and 26 females, aged 60 to 88 years with a mean of (75.4±4.8) years, with a cement volume of 2.0 to 3.0 mL (2.65±0.18) mL. The separated group included 15 males and 25 females, aged 60 to 86 years with a mean fo (75.3±4.8) years, with a cement volume of 2.0 to 3.0 mL (2.63±0.20) mL. Operative time, number of fluoroscopic exposures, and blood loss were recorded. The anterior height ratio and anterior-posterior height ratio of the injured vertebra, as well as the sagittal Cobb angle, were measured preoperatively and at 3 months and 1 year postoperatively. Functional disability was assessed using the Oswestry disability index(ODI), and pain was evaluated using the visual analogue scale (VAS).
RESULTS: All patients were followed up for at least one year. There were no significant differences between the two groups regarding operative time, fluoroscopic exposures, or blood loss(P>0.05). Preoperative anterior height ratio, anterior-posterior height ratio, and Cobb angle were comparable between the groups (P>0.05). At 3 months and 1 year postoperatively, both groups showed significantly increased height ratios and decreased Cobb angles compared to preoperative values (P<0.05). However, at these time points, the separated group exhibited significantly higher anterior and anterior-posterior height ratios and a smaller Cobb angle compared to the fused group (P<0.05). Both groups showed significant improvements in VAS and ODI scores at 3 months and 1 year compared to preoperative levels (P<0.001). Notably, the separated group demonstrated significantly lower VAS and ODI scores than the fused group at both 3 months and 1 year (P<0.05). Furthermore, the incidence of adjacent vertebral fractures was significantly higher in the fused group than in the separated group (P<0.05).
CONCLUSION: In OVCF patients treated with low-dose (2 to 3 mL) PVP, a separated bone cement distribution pattern yields superior clinical outcomes. It provides better restoration and maintenance of vertebral height and alignment, more effective pain relief, improved functional recovery, and a lower risk of adjacent vertebral fractures compared to a fused pattern. This technique holds significant clinical value.
METHODS: A retrospective analysis was conducted on 80 patients with OVCFs treated between March 2022 and March 2024. Based on postoperative imaging evaluation of bone cement distribution, patients were divided into a fused pattern group (fused group, n=40) and a separated pattern group (separated group, n=40). All cases received a single-level injection of 2 to 3 mL of bone cement. The fused group included 14 males and 26 females, aged 60 to 88 years with a mean of (75.4±4.8) years, with a cement volume of 2.0 to 3.0 mL (2.65±0.18) mL. The separated group included 15 males and 25 females, aged 60 to 86 years with a mean fo (75.3±4.8) years, with a cement volume of 2.0 to 3.0 mL (2.63±0.20) mL. Operative time, number of fluoroscopic exposures, and blood loss were recorded. The anterior height ratio and anterior-posterior height ratio of the injured vertebra, as well as the sagittal Cobb angle, were measured preoperatively and at 3 months and 1 year postoperatively. Functional disability was assessed using the Oswestry disability index(ODI), and pain was evaluated using the visual analogue scale (VAS).
RESULTS: All patients were followed up for at least one year. There were no significant differences between the two groups regarding operative time, fluoroscopic exposures, or blood loss(P>0.05). Preoperative anterior height ratio, anterior-posterior height ratio, and Cobb angle were comparable between the groups (P>0.05). At 3 months and 1 year postoperatively, both groups showed significantly increased height ratios and decreased Cobb angles compared to preoperative values (P<0.05). However, at these time points, the separated group exhibited significantly higher anterior and anterior-posterior height ratios and a smaller Cobb angle compared to the fused group (P<0.05). Both groups showed significant improvements in VAS and ODI scores at 3 months and 1 year compared to preoperative levels (P<0.001). Notably, the separated group demonstrated significantly lower VAS and ODI scores than the fused group at both 3 months and 1 year (P<0.05). Furthermore, the incidence of adjacent vertebral fractures was significantly higher in the fused group than in the separated group (P<0.05).
CONCLUSION: In OVCF patients treated with low-dose (2 to 3 mL) PVP, a separated bone cement distribution pattern yields superior clinical outcomes. It provides better restoration and maintenance of vertebral height and alignment, more effective pain relief, improved functional recovery, and a lower risk of adjacent vertebral fractures compared to a fused pattern. This technique holds significant clinical value.