The Impact of Bone Cement Distribution in Unilateral PVP on Therapeutic Outcomes of Vertebral Compression Fracture Repair.

BACKGROUND

Osteoporotic vertebral compression fractures (OVCFs) are common in the elderly, severely impacting health and quality of life. Percutaneous vertebroplasty (PVP) is a primary treatment, with bone cement distribution being a key factor influencing its efficacy.

OBJECTIVE

This study aimed to evaluate the impact of bone cement distribution patterns on clinical outcomes in unilateral PVP for OVCFs.

METHODS

A total of 145 patients undergoing first-time unilateral PVP were retrospectively analyzed. Based on postoperative anteroposterior X-rays, patients were divided into three groups according to cement coverage: Group A (uniform distribution across three vertebral regions, n=57), Group B (covering >1/2 to ≤2/3, n=51), and Group C (covering >1/3 to ≤1/2, n=37). Primary outcomes (VAS, ODI, vertebral height recovery, refracture rate) and secondary outcomes were compared.

RESULTS

At one-year follow-up, VAS scores were significantly lower in Groups A (2.12±0.54) and B (2.16±0.54) than in Group C (2.43±0.50, P<0.05). Vertebral height recovery was superior in Groups A and B compared to Group C (P<0.05). The overall refracture rate was significantly lower in Group A (3.6%) than in Group C (18.9%, P<0.05), with no significant difference from Group B (3.9%). Group A received a higher cement volume (4.95±0.43 mL) than Groups B and C (P<0.05).

CONCLUSION

Bone cement distribution crossing the vertebral midline is associated with better pain relief, improved vertebral height restoration, and a lower refracture rate after unilateral PVP. However, exceeding two-thirds vertebral coverage does not appear to be a critical factor for surgical efficacy.