Contralateral Supplementary Puncture When Poor Dispersion Of Bone Cement In Uni Lateral Percutaneous Vertebroplasty

ObjectiveTo investigate the clinical application value of contralateral supplementary puncture in unilateral percutaneous vertebroplasty(PVP)with poor cement dispersion.MethodsThe patients with osteoporotic vertebral compression fracture(OVCF)who underwent percutaneous vertebroplasty(PVP)from October 2017 to October 2018 in our orthopaedic department were randomly divided into intervention group(contralateral supplementary puncture)and control group(non-supplementary puncture)20 cases each.VAS score,sagittal Cobb angle,contralateral vertebral height,residual pain and re-fracture rate were recorded before,after and at the last follow-up.Following up for more than 6 months,the data were processed by SPSS V22.0 statistical software and the conclusion was drawn.ResultsAll patients completed the operation smoothly.No nerve root or spinal cord injury was found after the operation.During the follow-up period,40 patients did not fall off.There were no cases of residual pain in the intervention group and 3 cases of residual pain in the non-supplementary puncture group.The VAS scores of the two groups were significantly improved after operation,and there was significant difference before and after treatment(P<0.01).There was no significant difference in pain between the two groups after operation and at the last follow-up(P>0.05).The pain relief of the supplementary puncture group was more obvious than that of the control group.The sagittal Cobb of the affected vertebrae in the two groups improved significantly after operation(P<0.05),especially in the supplementary puncture group.Over time,the Cobb angle decreased in both groups(P<0.01),especially in the control group,but there was no significant difference between the two groups(P>0.05).The contralateral vertebral height of the two groups was significantly higher than that of the preoperative group(P<0.01),especially in the supplementary puncture group.At the last follow-up,the height of the contralateral vertebral body was lost in both groups,and the loss of the complementary puncture group was milder than that of the control group(P<0.05).ConelusionWhen poor cement dispersion occurs in unilateral PVP,contralateral supplementary puncture can effectively reduce the incidence of residual pain,restore Cobb angle and contralateral vertebral height,and effectively slow down the loss of Cobb angle and vertebral height.In order to achieve better therapeutic effect,when the dispersion of bone cement is not good,the contralateral supplementary puncture is a safe and reliable method and thought,which is worth further exploration.