The authors declare that they have no competing interests.
LZ participated in study design/data analysis and drafted the manuscript, and acted as first author. ZJL participated in the design of the study, analyzed the radiographic and functional measurements. XMF participated in the design of the study and carried out the operation. JCW assisted with funding, supervised the study design and data analysis, revised the manuscript and acted as the corresponding author. YPT assisted with clinical examinations and surgery. JDY participated in the design of the study and coordinated the research groups. SFZ participated in data collection and interpretation. All authors read and approved the final manuscript.
Percutaneous vertebroplasty (PVP) typically involves conventional lower-viscosity cement injection via bipedicular approach. Limited evidence is available comparing the clinical outcomes and complications in treating osteoporotic vertebral compression fractures (OVCFs) with PVP using high-viscosity cement through unipedicular or bipedicular approach.
Fifty patients with OVCFs were randomly allocated into two groups adopting unipedicular or bipedicular PVP. The efficacy of unipedicular and bipedicular PVP was assessed by comparing operation time, X-ray exposure time, incidence of complications, vertebral height restoration, and improvement of the visual analogue scale (VAS), Oswestry disability index (ODI) and Short Form-36 (SF-36) General Health Survey scores.
The mean operative and exposure time to X-rays in the unipedicular PVP group was less than that of the bipedicular group (p < 0.05). No statistically significant differences were observed in the VAS score, ODI score, SF-36 score, cement leakage rate or vertebral height restoration between the two groups (p > 0.05).
Unipedicular and bipedicular PVP are safe and effective treatments for OVCF. Compared with bipedicular PVP, unipedicular PVP entails a shorter surgical time and lower X-ray irradiation.
Litwic A, Cooper C, Dennison E. Osteoporosis therapies in 2014. Panminerva Med. 2014;56:273–83. PubMed
Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8:136. CrossRefPubMedPubMedCentral
Liu J, Li X, Tang D, Cui X, Yao M, Yu P, et al. Comparing pain reduction following vertebroplasty and conservative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials. Pain Physician. 2013;16:455–64. PubMed
Stevenson M, Gomersall T, Lloyd Jones M, Rawdin A, Hernandez M, Dias S, et al. Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2014;18:1–290. CrossRef
Lee MJ, Dumonski M, Cahill P, Stanley T, Park D, Singh K. Percutaneous treatment of vertebral compression fractures: a meta-analysis of complications. Spine (Phila Pa 1976). 2009;34:1228–32. CrossRef
He SC, Teng GJ, Fang W, Deng G, Guo JH, Zhu GY. [Value of intraosseous venography in percutaneous vertebroplasty for treatment of symptomatic vertebral hemangiomas]. Zhonghua Yi Xue Za Zhi. 2010;90:3188–92. PubMed
Bhatia C, Barzilay Y, Krishna M, Friesem T, Pollock R. Cement leakage in percutaneous vertebroplasty: effect of preinjection gelfoam embolization. Spine (Phila Pa 1976). 2006;31:915–9. CrossRef
Rapan S, Jovanovic S, Gulan G, Boschi V, Kolarevic V, Dapic T. Vertebroplasty--high viscosity cement versus low viscosity cement. Coll Antropol. 2010;34:1063–7. PubMed
Nieuwenhuijse MJ, Muijs SP, van Erkel AR, Dijkstra SP. A clinical comparative study on low versus medium viscosity polymethylmetacrylate bone cement in percutaneous vertebroplasty: viscosity associated with cement leakage. Spine (Phila Pa 1976). 2010;35:E1037–44. CrossRef
Huang H, He S, Fang W, Zhu H, Guo J, Deng G, et al. [Percutaneous vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: a retrospective analysis of clinical efficacy]. Zhonghua Yi Xue Za Zhi. 2014;94:2119–22. PubMed
Voormolen MH, Mali WP, Lohle PN, Fransen H, Lampmann LE, van der Graaf Y, et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. AJNR Am J Neuroradiol. 2007;28:555–60. PubMed
Anselmetti GC, Zoarski G, Manca A, Masala S, Eminefendic H, Russo F, et al. Percutaneous vertebroplasty and bone cement leakage: clinical experience with a new high-viscosity bone cement and delivery system for vertebral augmentation in benign and malignant compression fractures. Cardiovasc Intervent Radiol. 2008;31:937–47. CrossRefPubMed
Ruger M, Schmoelz W. Vertebroplasty with high-viscosity polymethylmethacrylate cement facilitates vertebral body restoration in vitro. Spine (Phila Pa 1976). 2009;34:2619–25. CrossRef
Chen C, Bian J, Zhang W, Zhao C, Wei H. Unilateral Versus Bilateral Vertebroplasty for Severe Osteoporotic Vertebral Compression Fractures. J Spinal Disord Tech. 2014;27(8):E301–4.
Gao W, Mi S, Gao J. [Percutaneous vertebroplasty to treat osteoporotic vertebral compression fractures combined with intravertebral clefts by unilateral approach]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26:1330–5. PubMed
Kaufmann TJ, Trout AT, Kallmes DF. The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2006;27:1933–7. PubMed
Li LH, Sun TS, Liu Z, Zhang JZ, Zhang Y, Cai YH, et al. Comparison of unipedicular and bipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures: a meta-analysis. Chin Med J (Engl). 2013;126:3956–61.
Steinmann J, Tingey CT, Cruz G, Dai Q. Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine (Phila Pa 1976). 2005;30:201–5. CrossRef
- Unipedicular versus bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a prospective randomized study
- BioMed Central
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