Clinical Efficacy Analysis Of Graded Infusion Of Bone Cement In The Treatment Of Osteoporotic Vertebral Compression Fractures With Vertebral Body Lateral Wall Breakage

Objective: To compare the graded infusion of bone cement with conventional PKP in the treatment of osteoporotic vertebral compression fractures with vertebral sidewall breakdown.Methods: Eighty patients with osteoporotic vertebral compression fractures treated surgically in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups of 40 patients each.One group was treated with the conventional PKP procedure,which was regarded as the single group,and the other group was treated with the graded infusion of bone cement,which was regarded as the graded group.All patients in the study had fresh fractures of a single vertebra and had a preoperative measured bone mineral density T value ≤-2.5 SD.The perioperative data of the two groups were recorded,including the duration of surgery,intraoperative bleeding,bone cement injection dose and incidence of bone cement leakage.And the clinical data of preoperative,postoperative 1 day and final follow-up were recorded for the two groups including visual analog pain score,Oswestry dysfunction index,height ratio of the anterior margin of the injured spine and local Cobb angle of the injured spine were recorded.The recorded data were statistically analyzed and compared to evaluate the fractionated bone cement infusion cement to treat osteoporotic vertebral compression fractures with vertebral body lateral wall breakdown.Results: Comparing the gender and age of the two groups,the preoperative visual analog pain score,Oswestry dysfunction index,the height ratio of the anterior margin of the injured vertebra and the local Cobb angle of the injured vertebra,the differences were not statistically significant(P > 0.05).The visual analog pain score,Oswestry dysfunction index,anterior vertebral height ratio and local Cobb angle of the injured spine were significantly improved in both groups at postoperative 1 day and at the final follow-up compared with preoperative(P <0.05);the visual analog pain score and Oswestry dysfunction index were significantly improved at the final follow-up compared with postoperative 1 day(P < 0.05).The height ratio of the anterior margin of the vertebral body at the final follow-up was lower than postoperative,the local Cobb angle of the injured vertebra was higher than postoperative,and the vertebral body height was slightly lost,with statistically significant differences(P < 0.05).Compared with the two groups,there were no statistically significant differences in visual analog pain score,Oswestry dysfunction index,anterior margin height ratio of the injured vertebra and local Cobb angle of the injured vertebra(P > 0.05).The operative time,intraoperative bleeding,and cement injection in the graded group were higher than those in the single group,and the differences were statistically significant(P < 0.05).There were 13 cases of bone cement leakage in the single group(32.5%)and 5 cases of bone cement leakage in the graded group(12.5%),and the difference was statistically significant compared with the two groups(P < 0.05).Conclusion: In patients with osteoporotic vertebral compression fractures,both graded infusion of bone cement and conventional PKP can effectively relieve pain and improve patients’ quality of life.Although the graded infusion of bone cement technique has slightly higher intraoperative bleeding and operating time than conventional PKP,it has better performance in terms of cement injection volume and prevention of cement leakage.In conclusion,we recommend the use of graded infusion of bone cement for the treatment of vertebral compression fractures with vertebral body lateral wall breakage.