Efficacy of Percutaneous Vertebroplasty Using Cross-Puncture in the Treatment of Genant Grade 0–1 Osteoporotic Vertebral Compression Fractures

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-02-11 DOI:10.1016/j.wneu.2024.123633

Guobing Hao, Zhenchuan Han, Nan Zhang, Kun Liu, Diyu Song, Shuming Zhang, Lin Qiao, Zexing Zhu

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引用次数: 0

Abstract

Background

Percutaneous vertebroplasty (PVP) is a common surgical method for osteoporotic vertebral compression fractures (OVCFs). The puncture method and location of the puncture needle can directly affect bone cement distribution in the vertebra. This retrospective study aimed to compare the clinical efficacy and safety of PVP using the cross-puncture and bilateral conventional puncture for the treatment of Genant grade 0–1 OVCFs.

Methods

We retrospectively analyzed 98 patients who underwent PVP in our department between January 2019 and April 2023, including 50 and 48 treated with the cross-puncture (group A) and bilateral conventional puncture (group B), respectively. Operation time (minutes), bone cement injection volume (mL), bone cement leakage rate, bone cement classification, and related complications were compared between the groups. The visual analog scale, Oswestry Disability Index, heights of the anterior and midline of the injured vertebrae, and Cobb angle were compared preoperatively and at the follow-up. Excellent and good operation rates were evaluated using the modified Macnab criteria.

Results

The bone cement leakage rate in group B (25%) was higher than that in group A (8%) (P < 0.05). However, the injection amount of bone cement in group A (5.47 ± 0.72 mL) was significantly higher than that in group B (4.43 ± 0.64 mL) (P < 0.001). The bone cement distribution grades in group A (40 cases of grade 3) were significantly better than those in group B (0 cases of grade 3) (P < 0.001). Compared with preoperative values, the visual analog scale and Oswestry Disability Index scores at each follow-up significantly decreased, anterior and midline heights of the injured vertebrae significantly increased, and Cobb angle significantly decreased in both groups (P < 0.001). The complication rate in group A (0%) was significantly lower than that in group B (10.42%) (P < 0.05). According to the modified Macnab standard, the excellent and good ratings in group A (96%) were significantly higher than those in group B (62.5%) (P < 0.001).

Conclusions

Cross-puncture and bilateral conventional puncture were both effective methods for the treatment of Genant grade 0–1 OVCFs. However, the cross-puncture was more advantageous in terms of the bone cement leakage rate, amount of bone cement injected, bone cement distribution grade, and complications.

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交叉穿刺经皮椎体成形术治疗Genant级0-1骨质疏松性椎体压缩性骨折的疗效观察。

背景：经皮椎体成形术（PVP）是治疗骨质疏松性椎体压缩性骨折（OVCFs）的常用手术方法。穿刺针的穿刺方法和位置直接影响椎体骨水泥的分布。本回顾性研究旨在比较PVP交叉穿刺与双侧常规穿刺治疗Genant级0-1级OVCFs的临床疗效和安全性。方法：回顾性分析2019年1月至2023年4月在我科行PVP手术的98例患者，其中交叉穿刺（A组）50例，双侧常规穿刺（B组）48例。比较两组手术时间（min）、骨水泥注射量（mL）、骨水泥漏出率、骨水泥分级及相关并发症。术前与随访比较视觉模拟评分（VAS）、Oswestry失能指数（ODI）、损伤椎体前中线高度、Cobb角。使用改良的Macnab标准评估优秀和良好的手术率。结果：B组骨水泥渗漏率（25%）高于A组（8%）。结论：交叉穿刺和双侧常规穿刺均是治疗Genant 0-1级OVCFs的有效方法。而交叉穿刺在骨水泥漏出率、骨水泥注入量、骨水泥分布等级、并发症等方面更有优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS