Implementing an Optimized Perioperative Strategy for Percutaneous Vertebroplasty: Clinical Application and Outcome Evaluation.

Abstract

Objective: Percutaneous vertebroplasty (PVP) is a widely used minimally invasive procedure for the treatment of osteoporotic vertebral compression fracture (OVCF), yet accelerating postoperative recovery and reducing complications remain critical clinical challenges that require urgent resolution. This study aimed to evaluate the clinical effectiveness of an optimized perioperative management strategy based on the Enhanced Recovery After Surgery (ERAS) concept in patients undergoing PVP.

Methods: From May 2022 to April 2024, a total of 301 patients with OVCF who underwent PVP were retrospectively enrolled in the retrospective cohort study. Using May 2023 as the implementation time point for the optimized perioperative management strategy in our department, all subjects were divided into the traditional group (155 cases) and the optimized strategy (ERAS) group (146 cases). The two groups were analyzed for visual analog scale (VAS) scores for low back pain at various time points before and after surgery, Oswestry Disability Index (ODI) at preoperative and 3 months postoperatively, postoperative first ambulation time, total length of hospital stay (LOS), postoperative LOS, postoperative rehydration volume, and postoperative complications. Group comparisons of continuous variables were performed using independent samples t-tests or Mann-Whitney U tests, while categorical variables were compared using χ² tests or Fisher's exact tests. p-value < 0.05 was considered statistically significant.

Results: Compared to the traditional group, patients in the ERAS group exhibited significantly lower VAS pain scores at 2 and 4 h postoperatively, earlier postoperative first ambulation time, shorter total and postoperative LOS, and reduced postoperative intravenous rehydration volume (p < 0.05). However, no statistically significant differences were observed between the two groups in preoperative VAS scores, VAS scores at 24 h postoperatively and on the day of discharge, as well as in ODI scores both preoperatively and at 3 months postoperatively (p > 0.05). Additionally, the complication rates were similar between the two groups (p > 0.05).

Conclusion: For patients with OVCF, performing PVP under the optimized perioperative management strategy facilitates early pain relief, reduces the average LOS, shortens the postoperative first ambulation time, and significantly improves perioperative clinical outcomes.