| Objective: The purpose of this study is to investigate the advantage of unipedicular approach vertebroplasty by comparing the clinical efficacy and differences between unipedicular and bipedicular approach vertebroplasty in the treatment of osteoporotic vertebral compression fractures.Methods: Totally 30 patients with 31 symptomatic vertebrae of osteoporotic vertebral compression fractures operated by vertebroplasty from June 2008 to October 2010 at the First Affiliated Hospital Of Shantou University were retrospectively analyses.All of them received more than 6 months'follow-up.They were divided into two groups on the basis of unilateral or bilateral of transpedicular operations.The unilateral group included of 7 men and 9 women with an average age of 67.8 (range from 55 to 82 years old).Only one vertebrate was involved in 15 cases,two vertebrates were involved in 1 cases. The bilateral group included of 6 men and 8 women, with an average age of 68.3 (range from 58 to 80 years old).Only one vertebrate was involved in all cases. The fracture of vertebral body was from T9 to L3, and it was confirmed that all cases were osteoporotic compression fractures by imaging studies preoperatively.All patients under the"C"type arm X-ray machine guided percutaneously finished the operation. Observation and analysis were conducted preoperatively and postoperatively. Observations included: surgical time, perspective times, visual analog pain score (VAS), activity ability score, and bone cement leakage. Statistical data results were compared between these two groups.Results: All patients tolerated the operation well.The average surgical time was (40.52±16.8)min for unilateral group and the perspective times were (12.65±3.24). The VAS was reduced to (2.4±1.5) from (7.6±1.8) preoperatively, and was (2.6±1.3) after 6 months'follow-up. Activity ability scores increased to (1.32±0.31) from (2.82±0.73) preoperatively, and was (1.41±0.48) after 6 months'follow-up. The average surgical time was (56.81±15.9)min for bilateral group and the perspective times were(22.32±4.58). The VAS was reduced to (2.3±1.3) from (7.6±1.5) preoperatively, and was (2.6±1.2) after 6 months'follow-up. Activity ability score increased to (1.20±0.44) from (2.82±0.73) preoperatively, and was (1.36±0.53) after 6 months'follow-up. Compared with these two groups, the surgical time and the perspective times were statistical significance differences(P <0.05); the preoperative and postoperative of VAS and activity ability scores between these two groups were statistical significance differences(P <0.05), while the postoperative and the 6 months'follow-up were no statistical significance differences(P >0.05). The recovery rate of VAS and activity ability scores between these two groups were no statistical significance differences(P >0.05). There was 1 case occured cement leakage in front of the vertebral body in the unilateral group, and there were 1case occured cement leakage in front of the vertebral body and 1 case occured cement leakage beside the vertebral body in the bilateral group respectively. There was no case of pulmonary embolism, cerebral embolism, spinal cord or nerve root injury and other complications. A mean follow-up postoperatively is 6 months. There is no alleviate pain in the operated vertebral body, no manifestation of delayed nerve injury, and no height loss of the operated vertebral body.Conclusion: Percutaneous vertebroplasty is a safe and effective minimally invasive method for treating osteoporotic vertebral compression fractures in elderly patients. Unipedicular approach vertebroplasty can not only achieve the same results of operations in the treatment of osteoporotic vertebral compression fractures, but also has the advantages of shorter surgical time, less radiation exposure, less trauma, and lower cost, so unipedicular approach vertebroplasty is a practical and effective method in the treatment of osteoporotic vertebral compression fractures. |
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