Unilateral Pedicular Puncture with Lateral Injection for Osteoporotic Vertebral Compression Fractures in the Upper and Middle Thoracic Vertebrae: A Technical Report and Efficacy Comparison.
Feng Huang, Yi Hang He, Lu Lin, Yun Cheng, Yang Wang, Xiao Lin Chen, Zhen Yong Ke
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引用次数: 0
Abstract
Background: Percutaneous vertebroplasty (PVP) for upper and middle thoracic osteoporotic vertebral compression fractures (OVCFs) is challenged by technical difficulties and safety concerns, which drive the need for innovative techniques to optimize its efficacy. The purpose of this study was to delineate the technical characteristics of a novel methodology and to conduct a comparative analysis of its efficacy against bilateral transpedicular puncture PVP.
Methods: A retrospective study was conducted on consecutive patients undergoing PVP for upper/middle thoracic OVCFs at the Second Affiliated Hospital of Chongqing Medical University (Chongqing, China) between January 2019 and December 2024. Patients were allocated to either the unilateral transpedicular puncture lateral injection (UTPLI) or the conventional bilateral transpedicular puncture (BTP) group based on the surgical timeline, with earlier cases undergoing BTP and later ones UTPLI. Baseline characteristics, operative time, estimated blood loss, cement volume, visual analogue scale (VAS), Oswestry disability index (ODI), vertebral and segmental kyphosis angles, anterior/middle/posterior vertebral heights, and postoperative cement distribution indices were recorded and compared between the two groups. Data were analyzed with SPSS software (version 26.0) using Chi square, t tests, and non-parametric tests.
Results: A total of 57 patients were enrolled (UTPLI group=21, BTP group=36). The UTPLI group had a shorter operation time (18.00±9.00 min vs. 25.00±9.00 min, P=0.002) and less estimated blood loss (3.93±1.22 mL vs. 5.13±1.37 mL, P=0.002). No significant intergroup differences were found in VAS, ODI, kyphosis angles (vertebral, segmental, thoracic), vertebral heights (anterior, middle, posterior), baseline data, bone cement leakage, cement dispersion index, or spatial distribution scores, either preoperatively or postoperatively (P>0.05).
Conclusion: The UTPLI technique is a viable alternative to BTP PVP for upper and middle thoracic OVCFs. It reduced operative time and blood loss while achieving comparable outcomes.
背景：经皮椎体成形术（PVP）治疗胸中上段骨质疏松性椎体压缩性骨折（OVCFs）面临技术困难和安全性问题的挑战，需要创新技术来优化其疗效。本研究的目的是描述一种新方法的技术特征，并对其对双侧经椎弓根穿刺PVP的疗效进行比较分析。方法：对2019年1月至2024年12月在重庆医科大学第二附属医院（中国重庆）连续接受PVP治疗的上/中胸ovcf患者进行回顾性研究。根据手术时间将患者分为单侧经椎弓根穿刺外侧注射（UTPLI）组和常规双侧经椎弓根穿刺（BTP）组，早期患者行BTP，晚期患者行UTPLI。记录两组患者的基线特征、手术时间、预估失血量、骨水泥体积、视觉模拟评分（VAS）、Oswestry残疾指数（ODI）、椎体和节段性后凸角、椎体前/中/后高度、术后骨水泥分布指标并进行比较。数据分析采用SPSS软件（26.0版），采用卡方检验、t检验和非参数检验。结果：共纳入57例患者（UTPLI组21例，BTP组36例）。UTPLI组手术时间短（18.00±9.00 min vs. 25.00±9.00 min， P=0.002），出血量少（3.93±1.22 mL vs. 5.13±1.37 mL， P=0.002）。术前、术后VAS、ODI、后凸角（椎体、节段、胸椎）、椎体高度（前、中、后）、基线数据、骨水泥渗漏、骨水泥弥散指数、空间分布评分均无组间差异（P < 0.05）。结论：UTPLI技术是一种可行的替代BTP PVP治疗上、中胸OVCFs的方法。它减少了手术时间和出血量，同时达到了相当的效果。
期刊介绍：
The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of communication for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science research experiences on prevalent diseases in the region and analysis of various regional problems.
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